The older patient: The ongoing challenge of efficacy and tolerability

The clinical management of older schizophrenic patients presents particular clinical challenges. Antipsychotics are among the most widely prescribed c lass of medications for elderly patients. However, the increased frequency of chronic illnesses and thus the potential need for polypharmacy means tha t the most appropriate treatment strategy for the older schizophrenic patie nt is not easily extrapolated from the wealth of clinical trials conducted in younger patients. The development of atypical antipsychotics, with their lower propensity to cause adverse effects and cognitive impairment, offers considerable potential benefits to the older schizophrenic patient. The pa rticular problems and key issues that should be addressed when selecting an appropriate antipsychotic for schizophrenic patients in this sensitive pop ulation, as well as the place of the new atypical antipsychotic agents in t reating this population, are discussed.