Proposed by the EPA sections on Psychopharmacology and Old Age Psychiatry-According to the data, more than 50% of elderly patients with mental disorders are treated with multiple drugs (e.g. 5 or more medications), which can lead to medically unnecessary polypharmacy (i.e., irrational polypharmacy). Due to frequent comorbidities and treatments in the elderly, polypharmacy is the rule rather than the exception and can lead to several harms, treatment failures, and inappropriate prescribing. Elderly patients on polypharmacy (rational and irrational) are also excluded from many clinical trials and consequently, this age group is underrepresented in meta-analyses and clinical guidelines as well, which leads to a lack of evidence-based medicine supported results useful for daily practice. In this context, the prudent deprescribing process is a key step in irrational polypharmacy reduction. The purpose of deprescribing is to reduce inappropriate polypharmacy, medication burden and harm, and to improve patient health-related outcomes. There are some tools available that can help in the deprescribing process in clinical practice, including different medication lists (e.g. Beers criteria, STOPP/START, and guidelines). This proposed joint workshop of the Section of Old Age Psychiatry and the Section of Psychopharmacology will address a neglected topic: why and when to use the deprescribing process of psychotropics in elderly patients in real clinical settings. Experts in psychiatry and psychopharmacology will specifically address the use of the deprescribing process of antidepressants, antipsychotics, hypnotics, and other psychotropics in this population. The participants will learn why is important to use deprescribing processes supported by evidence-based data and real clinical pharmacological tools useful for daily practice.

Proposed by the EPA sections on Old Age Psychiatry and Suicidology and Suicide Prevention -At advanced age, rates of males diverge even more from those of females. A better understanding of these factors may reduce the toll of suicide at these extreme ages as Prof. de Leo is going to discuss. Prof. Zeppegno will focus on the even twofold rate of suicidal behaviours when there is a chronic or terminal illness. Psychiatrists and geriatricians will likely meet mentally competent older adults expressing a wish to die: sometimes entangled with e.g.chronic illness, sometimes in the absence of terminal illness, but due to the feeling that they have already lived a completed life. The possibility of a "rational suicide" will be discussed. Prof. Stek is going to discuss the problem that in late life depression the clinical management of suicidality is often complicated by the presence of physical and neuropsychiatric comorbidity. Moreover, in The Netherlands the position of euthanasia in end of life choices may interfere with available diagnostic and treatment options. The challenges of well substanciated decision making in these situations will be discussed. Although interventions for suicide prevention are known, their relative effect for the elderly in general have not been explored. Prof. van der Feltz-Cornelis will discuss in her lecture what could be aspects of relevance for interventions in this specific age group. And finally Prof. Hegerl will show – at the example of a recent increase in gassing suicides – which role the media and especially the internet plays for the methods of suicide and what it could mean for suicide prevention.

Proposed by the EPA section on Old Age Psychiatry -The COVID 19 pandemic quickly showed that the older population is a risk group with particular vulnerability. This was particularly true for patients with dementia. They had difficulty understanding the situation, observing distance rules and using masks appropriately. The situation is particularly difficult in nursing homes. In many countries the visit of relatives and also doctors in nursing homes has been banned. Nevertheless, the proportion of people who died in these institutions was high in all countries, for example in Germany up to one third of deaths. What consequences this has and has had for nursing homes, relatives, dementia patients and the people caring for them is to be discussed in greater depth in this symposium, with particular attention being paid to ethical aspects. It will also be discussed which preventive measures can be derived for the future.