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In the elderly, long-term benzodiazepine therapy is a risk factor for amplifying cognitive decline, [29] although gradual withdrawal is associated with improved cognitive status. [30] A study of alprazolam found that 8 weeks administration of alprazolam resulted in deficits that were detectable after several weeks but not after 3.5 years. [31]
The authors, however, cited a study in younger patients who at a 3.5-year follow-up showed no memory impairments and speculated that certain memory functions take longer to recover from chronic benzodiazepine use and further improvements in elderly people's cognitive function may occur beyond 52 weeks after withdrawal.
Still some people do recover completely and additional numbers function well in society. [5] [6] Most people with schizophrenia live independently with community support. [1] In people with a first episode of psychosis a good long-term outcome occurs in 42% of cases, an intermediate outcome in 35% of cases, and a poor outcome in 27% of cases. [7]
POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive problems. Patients with POCD are at an increased risk of death in the first year after surgery. [9]
[1] [2] [4] [11] Recovery from the psychotic symptoms seems to be rare, and in most cases paraphrenia results in in-patient status for the remainder of the life of the patient. [ 1 ] [ 2 ] [ 9 ] Patients experience a slow deterioration of cognitive functions and the disorder can lead to dementia in some cases, but this development is no greater ...
[10] [11] A Japanese study of recovery from methamphetamine psychosis reported a 64% recovery rate within 10 days rising to an 82% recovery rate at 30 days after methamphetamine cessation. [12] However it has been suggested that around 5–15% of users fail to make a complete recovery in the long term. [13]
The mechanism of alcohol-related psychosis is due to distortions to neuronal membranes, gene expression, as well as thiamine deficiency. It is possible in some cases that alcohol abuse via a kindling mechanism can cause the development of a chronic substance-induced psychotic disorder (e.g., schizophrenia).
The provision of optimal treatments in these early years is thought to prevent relapses and reduce the long-term impact of the condition. It is considered a secondary prevention strategy. The duration of untreated psychosis (DUP) has been shown as an indicator of prognosis, with a longer DUP associated with more long-term disability. [7]