Side effects of antipsychotic drugs - Avoiding and minimizing their impactin elderly patients

Antipsychotic drugs are very useful in treatment of psychosis and severe ag itation in the elderly. Their use for other behavioral problems is contrain dicated. Antipsychotics have many potential side effects (eg, sedation, car diovascular effects, anticholinergic effects, incontinence, reduced appetit e, such motor disturbances as drug-induced parkinsonism, akathisia, dystoni a, TD). Prevention, by using the minimum dose and duration of treatment possible, i s the key to managing motor side effects. Ii prevention fails, drug-induced parkinsonism and dystonia may improve with use of anticholinergics, and ak athisia may improve with use of benzodiazepines or low-dose propranolol. Th ere is no proven treatment for TD, which is most likely to be observed duri ng dose reduction or after discontinuation of antipsychotic drugs. Compared with older agents, newer antipsychotic drugs are less likely to ca use parkinsonism, akathisia, and dystonia and may cause TD less often. More research is needed to clarify use of the new drugs in the elderly.