Psychosis in late life - Spotting new-onset disorders in your elderly patients

Elderly patients with psychosis typically respond well to conventional drug therapy at dosages one fifth to one third of those given to younger patients. Several new ''atypical'' antipsychotic drugs block serotonin (5-hydroxytryptamine [5HT]) at the 5HT(2) receptor as well as block dopamine at the D-2 receptor: clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), and sertindole. Although relatively little research has been done on their use in elderly patients, these drugs may offer an improved side-effect profile over more commonly used neuroleptics (eg, haloperidol). Attention to the multiple side effects of psychotropic medications, as well as to drug interactions, is imperative in this Population.(8,9).