Which antipsychotic is considered relatively safer for elderly patients with psychosis?

Which antipsychotic is considered relatively safer for elderly patients with psychosis?

• A. Olanzapine
• B. Quetiapine
• C. Haloperidol
• D. Risperidone

Answer: (B)

Elderly patients with psychosis are particularly vulnerable to movement disorders and delirium from antipsychotics, so safety and tolerability often guide choice. Haloperidol, a high-potency typical antipsychotic, carries a high risk of extrapyramidal symptoms and falls in older adults. Quetiapine tends to have the gentlest motor side‑effect profile because its dopamine D2 blockade is weaker and more transient, which lowers the likelihood of extrapyramidal symptoms and tardive dyskinesia. It also usually avoids as much prolactin elevation and severe metabolic burden as some other atypicals, making it comparatively better tolerated. Sedation and orthostatic effects can occur with quetiapine, but overall many clinicians view it as safer for older patients with psychosis. Still, all antipsychotics carry risks in the elderly, so start low, go slow, and monitor closely, especially if dementia-related symptoms are present.

Elderly patients with psychosis are particularly vulnerable to movement disorders and delirium from antipsychotics, so safety and tolerability often guide choice. Haloperidol, a high-potency typical antipsychotic, carries a high risk of extrapyramidal symptoms and falls in older adults. Quetiapine tends to have the gentlest motor side‑effect profile because its dopamine D2 blockade is weaker and more transient, which lowers the likelihood of extrapyramidal symptoms and tardive dyskinesia. It also usually avoids as much prolactin elevation and severe metabolic burden as some other atypicals, making it comparatively better tolerated. Sedation and orthostatic effects can occur with quetiapine, but overall many clinicians view it as safer for older patients with psychosis. Still, all antipsychotics carry risks in the elderly, so start low, go slow, and monitor closely, especially if dementia-related symptoms are present.