Why should caution be used with antipsychotic medications in older adults?

Caution is particularly important when prescribing antipsychotic medications to older adults primarily due to the increased risk of falls. This population often has age-related physiological changes, including decreased muscle strength, balance issues, and potential cognitive impairments, which can be exacerbated by the sedative effects and potential orthostatic hypotension associated with antipsychotic medications. These factors collectively elevate the likelihood of falls, which can lead to serious injuries such as fractures or head trauma.

In contrast, while kidney damage and weight gain are concerns associated with any medication, they are not specific to older adults and do not directly address the immediate risks posed by altered balance and falls. Faster recovery is also not a typical effect of antipsychotic medications; rather, these agents generally stabilize symptoms over the long term rather than promote rapid improvement. Therefore, it is critical to consider fall risk when evaluating the safety and appropriateness of antipsychotic therapy in geriatric patients.