Clinical experience with quetiapine in elderly patients with psychotic disorders

Quetiapine fumarate is a recently marketed atypical antipsychotic medicatio n proved to be effective in the treatment of schizophrenia and schizoaffect ive disorder in the younger population. There is a paucity of studies of th is drug in the elderly and more data are needed on the effects of quetiapin e in this population, especially those with comorbid medical illnesses. Que tiapine was used to treat seven elderly hospitalized patients between 61 an d 72 years of age who manifested signs of psychosis related to schizophreni a, schizoaffective disorder, or bipolar disorder. All patients had been tre ated previously with conventional antipsychotics or other atypical antipsyc hotics. Response was assessed by observation of patient's behavior. Four pa tients responded to treatment; three did not respond, Positive symptoms dec reased markedly in all four responders, Negative symptoms showed marked-dec rease in two patients and moderate decrease in one patient. Preexisting ext rapyramidal symptoms (EPS) diminished in three patients. Transient hypotens ion, dizziness, and somnolence occurred in two patients. No other side effe cts were noted. No adverse consequences occurred when lithium, carbamazepin e, valproic acid, or venlafaxine was given concurrently. The reduction of p ositive and negative symptoms of schizophrenia and lack of significant EPS and minimal sedative, hypotensive, and anticholinergic side effects indicat e that quetiapine may be a safe and effective medication for the elderly.