[Antipsychotics in geriatric institutions]

The present paper approaches the use of antipsychotics in elder people in general, and particularly in geriatric institutions. During the last few years, prescription of antipsychotics in geriatric institutions increased, especially because of the availability of the atypicals, and their use was extended beyond the indications these drugs had been approved for. In dementia they are suggested for treatment of behavioral symptoms, despite having been approved only for cases of aggressiveness and risk of damage. There is a common tendency of perpetuating antipsychotic medication in elder people, with its consequent collateral effects as well. Few years ago, the increase of both risk of cerebrovascular events and of mortality in dementia patients treated with atypical agents was noticed. This generated controversy regarding their use in those kind of patients. Diverse factors associated to caregivers affect the decision of prescribing an antipsychotic in elder people. Non-pharmacological interventions are the first choice when treating behavioral symptoms; pharmacological interventions must take place with the lowest doses possible, with limited durations.