Recent advances in pharmacological treatment of psychosis in late life

Psychosis is among the most frequent psychiatric symptoms in late life. Treatment of late life psychosis is often challenging because of age-related changes, physical comorbidities and frailty of older adults. The present study aims at reviewing recent literature on pharmacological treatment of psychosis in the older population.

Recent studies show that antipsychotics remain the mainstay of treatment for older adults with psychosis. Although the efficacies of both typical and atypical antipsychotics have been demonstrated in older adults with schizophrenia, delirium and Parkinson's disease psychosis, there is a growing body of data favoring atypical antipsychotics. However, most of the evidence is not based on rigorously conducted trials. In addition, the use of antipsychotic medication in managing psychosis associated with dementia has declined significantly with the recognition of its serious adverse effects in this vulnerable population. A recent study suggests that effective alternative treatments are yet to be developed.

Studies have demonstrated the clinical benefits of antipsychotics in older people with psychosis. The potential benefits from the use of antipsychotics must be weighed against their adverse effects.