Side Effects of Antipsychotics in the Elderly

Side effects of antipsychotic medications are particularly problematic in elderly patients, who experiencemany age-related changes that may exacerbate medication side effects. Side effects of particularconcern in the elderly include anticholinergic reactions, parkinsonian events, tardivedyskinesia, orthostatic hypotension, cardiac conduction disturbances, reduced bone mineral density,sedation, and cognitive slowing. In addition, elderly patients with schizophrenia often have comorbidmedical illnesses—such as cardiovascular disease and dementia of the Alzheimer’s type—and arethus likely to be taking multiple medications. The effects of polypharmacy must be carefully considered.Patients, caregivers, and family often have different perspectives on side effects. This article addressesthe side effects of the currently available antipsychotic medications in light of these concerns.