Safety profiles of atypical antipsychotics in the elderly

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Abstract

The advent of atypical antipsychotics has allowed for the treatment of psychosis with improved patient tolerability compared with conventional neuroleptics. Atypicality has been defined in terms of fewer extrapyramidal symptoms, as well as enhanced efficacy against the negative symptoms of schizophrenia. However, the atypical antipsychotics are not a panacea for psychosis; they are not without their own potential for adverse effects. In the geriatric population, the use of antipsychotics has been extended to include the treatment of behavioral sequelae associated with dementia and delirium, especially in the nursing home setting. Compared with their younger counterparts, special consideration must be given for elderly patients in light of physiologic differences associated with aging and an increased prevalence of comorbid medical conditions. These differences can potentially reduce tolerability of these medications. This review examines the evidence for particular adverse effects associated with aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone in the older patient population.