Typically hallucinations are associated with conditions such as schizophrenia, dementia, delirium (acute confusional state), or side effects from medications or street drugs. In many cases hallucinations require treatment with antipsychotic medications. However, there are some circumstances where treatment with such medications is unnecessary.
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Many correctional systems classify their inmates as “elderly” beginning at age 55. Some do so as early as age 50.
Why?
In general, inmates age faster than the non-incarcerated. The stress of incarceration, substance abuse, and the lack of access to medical care before incarceration are some of the more significant contributors to the accelerated aging.
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As a psychiatrist who has now been practicing for over a decade, I think back to the days of residency and fellowship and realize how much my approach to prescribing benzodiazepines has changed.
One of the key faculty members in my psychiatry residency program was considered an expert in treating anxiety disorders. He was very liberal with his prescription of benzodiazepines, the anti-anxiety class of medications including diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), alprazolam (Xanax) and others.
Having no other frame of reference, I naively adopted his unsparing prescription-writing habit of these not-so-benign medications. I unquestioningly steered down this path for the first couple years of my post-training practice.
Then I had the good fortune of working with a very competent group of experienced psychiatrists who were in full-time clinical practice. Regularly collaborating on cases with them helped to initiate my transformation to more conservative, and in my opinion, more appropriate, prescribing habits.
My prescription style inevitably evolved further when
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