Older patients drug research

As with most of the older psychotropic drug, dose-response curves for clozapine have not been developed until recently. In a blinded, controlled study, Simpson and coworkers (330) randomized patients into three doses of clozapine 100, 300, and 600 mg. These researchers found that 600 mg was more effective than 300 mg and that doses up to 400 mg/day usually produce inadequate plasma levels. Thus, the results of this dose-response study are consistent with the plasma level studies. 

Schizoid Personaiity Disorder (SPD). Again, there is very little research to guide in the selection of medications to treat the schizoid patient. If we conceptualize the symptoms of SPD as most resembling the negative symptoms of schizophrenia, the choice of agents would tend to favor the atypical antipsychotic drugs as opposed to the older typical antipsychotics. Consequently, we also recommend low doses of an atypical antipsychotic as a first-line treatment for SPD. 

Some research dollars are pursuing new classes of drugs, which may supplant older therapies or create new markets in areas where there was before no effective therapy. Several companies have current research programs on drugs for Alzheimer s disease, a major cause of dementia in older people, but so far no drug can offer substantial improvements in patient functioning. (See chapter 5, box 5-E for more information on... 

The possibility of hereditary factors has been raised on many occasions. Although animal experiments suggest that such factors do exist, recent research on this subject in man is scanty. All that can be gleaned from the older literature is that the existence of any such influence remains uncertain. It is nevertheless claimed that patients with an atopic predisposition or with the lupus erythematosus diathesis are more prone to drug reactions than normal people. 

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