Understanding of Antipsychotics in Elderly Patients with Dementia

Behavioral and psychological symptoms are often apparent and major issues in elderly patients with dementia, and are potentially the cause of the caregiver’s stress, thus leading these patients to nursing homes. Aging is a major risk factor for dementia, and using antipsychotics due to behavioral psychological symptoms in dementia (BPSD) present a challenge task in geriatric psychopharmacology, which is complicated not only by the effects of normal aging but by co-morbid medical illness. Elderly patients often present with subclinical syndromes or symptoms that are modified by co-morbid disease or partial treatment. Antipsychotics were and are frequently used for the treatment of BPSD. However, in recent years, the use of antipsychotics (both conventional and atypical) has been widely debated for their efficacy in treating behavioral disturbances and the possible serious adverse events in elderly patients with dementia.1-3 In the past, using conventional antipsychotics in the elderly patients with BPSD was strongly limited by their severe adverse events,4,5 whereas atypical antipsychotics were believed to have a far milder adverse effect profile than their older counterparts. However, several recent studies have raised questions about this belief.1,2 In 2002, trials with risperidone and olanzapine in elderly psychotic patients with dementia isUnderstanding of Antipsychotics in Elderly Patients with Dementia