Risperidone for Psychogeriatric Patients

Elderly patients with dementia, delirium, schizophrenia and other psychotic symptoms are appropriate candidates for antipsychotic treatment. Risperidone is one of the atypical antipsychotic agents that block serotonin and dopamine receptors and does not potently block histamine or cholinergic receptors. Its unique pharmacologic profile should make advantages for elderly patients. Elderly patients are usually more susceptible to the adverse effects of antipsychotics. Compared with young patients, elderly patients who use risperidone have an increased risk of postural hypotension, sedation, EPS and tardive dyskinesia. The starting and maintenance dosages of risperidone in elderly patients therefore have to be much lower than those recommended for younger patients. Clinicians who prescribe antipsychotics, including risperidone, for elderly patients should start with a lower initial dosage and increase slowly until the lowest effective dosage is reached. Polypharmacy is also one of seriously concerned issues among elderly patients, who are often being treated for various medical problems. Clinicians should avoid prescribing multiple drugs with anticholinergic or sedative effects.