Conventional vs. newer antipsychotics in elderly patients

Elderly patients with schizophrenia and dementia patients with agitation ar e frequently candidates for antipsychotic treatment. Conventional neurolept ics have relatively little effect on negative symptoms and may cause consid erable side effects, especially in elderly patients. The authors have found a 29% cumulative annual incidence of tardive dyskinesia (TD) in middle-age d and elderly outpatients treated with relatively low doses of conventional neuroleptics. Newer antipsychotics are less likely to cause extrapyramidal symptoms and may be associated with a lower risk of TD. They are generally effective for both positive and negative symptoms and may also improve som e aspects of cognition, but these drugs have their own side effects. Dosing requirements for elderly patients tend to be much lower than those for you nger adults.