Antipsychotics in late-life schizophrenia – a narrative review

The number of people with late-life schizophrenia is increasing, but few prospective longitudinal studies have analysed antipsychotic use in this group. The aim of this narrative review is to present key points of current knowledge regarding the use of antipsychotics in late-life schizophrenia. In general, antipsychotic medications have had a major impact on symptom relief in schizophrenia. If used with caution, they are relatively safe and effective in older patients. Given the significant somatic comorbidity and excess mortality in late-life schizophrenia, treatment approaches should include a combination of judicious use of antipsychotics with non-pharmacological treatments. Antipsychotics should be used cautiously with the goal of optimizing outcomes with regular monitoring of adverse effects and using lowest effective doses. Cessation of antipsychotic treatment may be possible for some patients.