LYCOS RETRIEVER 
Psychosis: Patients
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Not all physicians are comfortable issuing a diagnosis of hospital psychosis. Some of the same symptoms may be attributed to the effects of sedatives or anesthesia. Elderly patients who do not receive the normal day/night light cues may develop another condition called sundowners syndrome. They may experience hallucinations or exhibit confused speech, but this is more akin to early Alzheimer's disease than an actual psychotic break. If hospital psychosis becomes evident, the patient may receive anti-depressants to counteract the hallucinations and disconnection with reality.
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Delusions, incorrect beliefs about reality, are another symptom of psychosis. There are various types of delusions. Delusional patients may believe they are extremely important and powerful, or that they have a special relationship with a political leader, a Hollywood star, or God. Other delusional patients may feel they are being persecuted or mistreated by someone when no such persecution or mistreatment is taking place. Further delusions include unwarranted jealousy or the strongly held belief that one suffers from a disease or physical defect.
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The experts were polled on the treatment of the various causes and symptoms of agitation -- such as psychosis, aggression, depression and insomnia -- in 33 different clinical situations. Their responses were then analyzed and summarized, including recommendations for the use of specific medications and environmental interventions for different patient types and symptoms. The guidelines ... provide a more precise method for assessing agitation in elderly patients with dementia. The underlying cause of agitation must be identified before specific treatments are selected.
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Cerebrovascular adverse events (CVAE), including stroke, in elderly patients with dementia -- Cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, were reported in patients in trials of olanzapine in elderly patients with dementia-related psychosis. In placebo-controlled trials, there was a significantly higher incidence of CVAE in patients treated with olanzapine compared to patients treated with placebo. Olanzapine is not approved for the treatment of patients with dementia-related psychosis.
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Zyprexa is not approved for the treatment of patients with dementia- related psychosis. Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared with those patients taking a placebo. In addition, compared to elderly patients with dementia-related psychosis taking a placebo, there was a significantly higher incidence of cerebrovascular adverse events in elderly patients with dementia-related psychosis treated with Zyprexa.
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Treatment varies depending on the cause of the psychosis. Care in a hospital is often needed to ensure the patient's safety. Drugs that diminish auditory hallucinations ("hearing voices") and delusions, and stabilize thinking and behavior (antipsychotic drugs) are helpful. Group or individual therapy can ... be useful.
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