Pharmacological and Clinical Profile of Recently Approved Second-Generation Antipsychotics: Implications for Treatment of Schizophrenia in Older Patients

Antipsychotics are frequently used in elderly patients to treat a variety of conditions, including schizophrenia. While extensively studied for their impact in younger populations, there is comparatively limited evidence about the effectiveness of these agents in older patients. Further complicating...

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Bibliographic Details
Published in:Drugs & aging 2012-10, Vol.29 (10), p.783-791
Main Authors: Rado, Jeffrey, Janicak, Philip G.
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Antipsychotic Agents - adverse effects
Antipsychotic Agents - pharmacokinetics
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Antipsychotics
Biological and medical sciences
Drug Approval
Geriatrics/Gerontology
Humans
Internal Medicine
Medical sciences
Medicine
Medicine & Public Health
Pharmacology. Drug treatments
Pharmacology/Toxicology
Pharmacotherapy
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Review Article
Schizophrenia
Schizophrenia - drug therapy
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Summary:Antipsychotics are frequently used in elderly patients to treat a variety of conditions, including schizophrenia. While extensively studied for their impact in younger populations, there is comparatively limited evidence about the effectiveness of these agents in older patients. Further complicating this situation are the high comorbidity rates (both psychiatric and medical) in the elderly; age-related changes in pharmacokinetics that lead to a heightened proclivity for adverse effects; and the potential for multiple, clinically relevant drug interactions. With this background in mind, we review diagnostic and treatment-related issues specific to elderly patients suffering from schizophrenia. We then focus on the potential role of the most recently approved second-generation antipsychotics, paliperidone (both the extended-release oral formulation and the long-acting injectable formulation), iloperidone, asenapine and lurasidone, given the limited clinical experience with these agents in the elderly. While there is limited data to support their safety, tolerability and efficacy in older patients with schizophrenia, each has unique characteristics that should be considered when used in this population.
ISSN:1170-229X
1179-1969
DOI:10.1007/s40266-012-0009-0