Which medication is contraindicated with ACE inhibitors in older adults?

The use of lithium in combination with ACE inhibitors can lead to increased lithium levels and a higher risk of lithium toxicity, particularly in older adults. ACE inhibitors can decrease lithium clearance by affecting renal function, making it important to monitor lithium levels closely when these medications are used together. Older adults are often more susceptible to the side effects of medications due to factors such as decreased renal function and altered drug metabolism, making this interaction particularly critical in this population.

The other medications listed do not have the same level of contraindication when used with ACE inhibitors. Quetiapine, risperidone, and aripiprazole are antipsychotics that do not have significant interactions with ACE inhibitors that would warrant contraindication. Therefore, among the options provided, lithium stands out as the medication that presents a notable risk when taken concurrently with ACE inhibitors in older adults.