Psych CASC / OSCE · Old age psychiatry — psychopharmacology
Explain safer prescribing and antipsychotic risks to family — CASC communication station
MRCPsych/FRANZCP-style communication station: explain geriatric psychotropic safety, Beers-type caution, antipsychotic mortality/stroke risk, deprescribing, and when medicines may still be used.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar reviewing residential care medications with the resident's daughter. [1]
Candidate instructions. Explain in plain language why long-term risperidone and night temazepam are being reviewed; summarise mortality/stroke concerns with antipsychotics in dementia without causing panic; outline non-drug approaches for calling out; describe a supervised taper and what happens if severe aggression returns; check understanding. Examiner plays the daughter. [1][2][3]
References5ShowHide
- [1]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
- [2]Ballard C, Lana MM, Theodoulou M, et al. A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD trial) PLoS Med, 2008.PMID 18384230
- [3]By the 2023 American Geriatrics Society Beers Criteria Update Expert Panel American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults J Am Geriatr Soc, 2023.PMID 37139824
- [4]Glass J, Lanctôt KL, Herrmann N, et al. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits BMJ, 2005.PMID 16284208
- [5]Devanand DP, Mintzer J, Schultz SK, et al. Relapse risk after discontinuation of risperidone in Alzheimer's disease N Engl J Med, 2012.PMID 23075176