The clinical features of involutional psychosis (first episode) are similar to those for the first episode of schizophrenia (first episode): age < 40, absence of family history of psychotic disorders, absence of prodynin in first episode, and rapid recovery without overt psychotic symptoms.
Recent findings are to a greater extent similar to those obtained for psychosis. The drugs that are most frequently used are as follows: antipsychotics and antidepressants, and the most common psychotropic medication type used in case of involuntary commitment is quetiapine.
The causes of psychosis in dementia and schizophrenia are similar, and the cause may be related to the age of onset of psychosis, the presence of underlying vascular or medical conditions, or the severity of impairment. There may be common pathogenic mechanisms involved in the two psychoses.
Treatment-resistant psychosis can be cured in a high proportion of people. We conclude that (1) antipsychotics must be tapered off in as many people as is required to achieve clinical response. (2) the majority of people experiencing persistent psychotic symptoms require pharmacotherapy. (3) the majority of these people should be treated with psychoses, as there is evidence that such therapies are superior for schizophrenia to long-term antipsychotics and that they may even be as efficacious without side effects in the long term.
The American Psychosis Society estimate the number of people with an acute episode of psychosis who will be diagnosed in each 5-year interval, and the data show an increase comparable to reports from the United Kingdom (4.28 in 2000 to 9.26 in 2011). There was no significant change from 1994 to 1999. The rate for the United States in 2000-2010 was 8.14 per 100,000 population and remained relatively stable at about 11 per 100,000 from 1999-2010.
These data suggest that pregnenolone may be an alternative treatment for people at risk of developing psychosis associated with hormone deprivation. A long-term randomized, placebo-controlled design is required to validate the efficacy of pregnenolone.
Results from a recent clinical trial suggest that low doses of the steroid Pregnenolone should be viewed as safe when used to treat androgen deficiency in elderly patients. Higher doses of Pregnenolone might be safely used for this purpose.
Pregnenolone is metabolized in the liver to DHEAs and testosterone. At low dose, DHEAs are used in the male accessory gland (e.g. the prostate gland). As such, DHEA therapy may be useful in some female sexual dysfunction. While the therapeutic use of DHEA is still in use, the present study demonstrates that both testosterone and DHEA increase and maintain self-reported sexual fantasies and, thus, support the notion for further investigations into the role of DHEA in female sexual response.
Pregnenolone is indicated for the treatment of mood disorders such as depression and anxiety, but its use in combination with other psychotropic drugs, including antidepressants, anxiolytics, and mood stabilizers, is not usually warranted.
Pregnenolone at 1.5 mg daily had a beneficial cognitive effect through improving positive and negative symptoms of psychosis and improves HRQOL for dementia patients with psychosis.
There is little recent research on psychosis or involution. There are currently no large longitudinal studies examining the onset of clinical manifestations of psychosis and cognitive decline in the early years. Future research may use the 'big data' accumulating in national registers such as the National Health Service (NHS) and disability registers. Clinicians may benefit from the evidence gathered from these prospective studies.