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Current Treatment Options in Psychiatry

Erschienen in:

01.03.2018 | Schizophrenia and Other Psychotic Disorders (J Csernansky, Section Editor)

Epigenetic Alterations Impact on Antipsychotic Treatment in Elderly Patients

verfasst von: Bryan M. McClarty, BS, Daniel W. Fisher, PhD, Hongxin Dong, MD, PhD

Erschienen in: Current Treatment Options in Psychiatry | Ausgabe 1/2018

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Abstract

Purpose of the review

Antipsychotics are commonly prescribed for the treatment of psychosis as well as behavioral and psychological symptoms of dementia (BPSD) in elderly patients. However, elderly patients often experience decreased antipsychotic efficacy and increased side effects, though the mechanisms underlying these changes with age are not clear.

Recent findings

Although aging can affect drug metabolism and clearance through changes in renal and hepatic function, additional pharmacokinetic and pharmacodynamic changes due to aging-induced epigenetic alterations also impact processes important for antipsychotic function. Epigenetic mechanisms account for some of the altered efficacy and increased side effects seen in elderly patients.

Summary

Both clinical and animal studies from our group and others have demonstrated a plausible epigenetic mechanism involving histone modifications that can adversely affect the efficacy of antipsychotics and increase their side effects in elderly patients. Hopefully, further investigation of this mechanism will benefit elderly patients who need treatment for psychosis and BPSD.

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Titel: Epigenetic Alterations Impact on Antipsychotic Treatment in Elderly Patients
verfasst von: Bryan M. McClarty, BS
Daniel W. Fisher, PhD
Hongxin Dong, MD, PhD
Publikationsdatum: 01.03.2018
Verlag: Springer International Publishing
Erschienen in: Current Treatment Options in Psychiatry / Ausgabe 1/2018
Elektronische ISSN: 2196-3061
DOI: https://doi.org/10.1007/s40501-018-0134-4

Psychosocial Treatment of Irritability in Youth

Child and Adolescent Psychiatry (M Brotman, Section Editor)

Use of Antipsychotic Medications in Non-Substance-Related Delirium—the Gap Between Research Findings and Clinical Practices

Schizophrenia and Other Psychotic Disorders (J Csernansky, Section Editor)

Antipsychotic Pharmacotherapy for Neuropsychiatric Symptoms of Dementia

Schizophrenia and Other Psychotic Disorders (J Csernansky, Section Editor)

Identifying and Treating the Prodromal Phases of Bipolar Disorder and Schizophrenia

Child and Adolescent Psychiatry (M Brotman, Section Editor)

Treatment Implications for ADHD Youth with Mood and Anxiety Comorbidity

Child and Adolescent Psychiatry (M Brotman, Section Editor)

Symptom Dimensions in Obsessive-Compulsive Disorder as Predictors of Neurobiology and Treatment Response

Anxiety, Obsessive Compulsive, and Related Disorders (CB Nemeroff, Section Editor)

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Epigenetic Alterations Impact on Antipsychotic Treatment in Elderly Patients