The efficacy, safety, and tolerability of antipsychotics in the elderly

Antipsychotic medications are among the most widely prescribed class of med ications for elderly patients. Despite their high use, few studies document the efficacy, safety, and tolerability of these agents in this patient pop ulation. This is unfortunate because, as a group, the elderly are exception ally sensitive to the adverse effects associated with antipsychotics, in pa rticular, the extrapyramidal side effects (EPS). The atypical antipsychotic s with their lower propensity to cause EPS and lower need for augmenting an ticholinergic medication have introduced new options for elderly patients w ho need antipsychotic therapy for a number of psychiatric and neurologic di sorders with psychotic manifestations. This review covers the pharmacologic , clinical, and regulatory issues involving antipsychotic use in elderly pa tients that warrant consideration by the practicing psychiatrist.