The management of psychosis in geriatric patients requires particular attention to adverse effects and potential co-morbidities. Patients with Alzheimer’s dementia are particularly sensitive to EPS possibly due to a natural decline in the number of dopaminergic neurons with age. In addition to EPS, metabolic abnormalities, orthostatic hypotension, somnolence, and QTc prolongation, can also be of concern, depending on the agent and dosage required. Furthermore, a number of agents commonly used in the elderly can increase the risk of sedation, impaired cognition, and falls. Variations in adverse effect profiles between agents and the special needs of elderly patients warrant particular consideration when selecting an antipsychotic therapy.
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