CLOZAPINE TREATMENT IN GERIATRIC-PATIENTS

The atypical antipsychotic clozapine has been reported to be effective in otherwise refractory psychoses. This, and its low potential for in ducing extrapyramidal side effects and tardive dyskinesia, predestines this drug for the treatment of psychotic disorders in late life. Howe ver, not much is known about the efficacy, safety and pharmacokinetics of clozapine in the treatment of aged patients. There are some studie s and reports available about clozapine in the treatment of psychosis in patients suffering from dementia, schizophrenia and Parkinson's dis ease, which are reported here. They give some evidence that even low d oses of clozapine are effective in controlling psychotic symptoms in t he elderly. To avoid side effects, patient-specific factors and change s of pharmacokinetics in the elderly have to be considered. However, s ide effects including sedation, delirium, posturnal hypotension and th e risk of agranulocytosis in particular, limits the use of clozapine i n elderly patients.