Medications for elderly people and people with late-onset schizophrenia

What is late-onset schizophrenia?

Studies of the life course of schizophrenia suggest that positive symptoms tend to reduce with time, while negative symptoms, such as social withdrawal and emotional apathy, increase with time. In contrast, people with late-onset schizophrenia (onset after 40 years of age) and very late-onset schizophrenia (onset after 60 years of age) tend to have predominant positive symptoms and fewer negative symptoms.

This summary table includes both elderly people with chronic schizophrenia, and people who have been diagnosed with late-onset or very late-onset schizophrenia.

What is the evidence for medications for older people with  schizophrenia?

Moderate to high quality evidence finds a medium-sized benefit for overall symptoms, particularly negative symptoms, with olanzapine than with haloperidol in people with schizophrenia who are over 46 years of age There were no significant differences in symptoms for older patients between amisulpride and risperidone, chlorpromazine and clozapine, olanzapine and risperidone or quetiapine and risperidone.

There were fewer drop-outs with olanzapine than with risperidone, less prolactin increase with olanzapine than with haloperidol or risperidone, and less antiparkinson medication with olanzapine than with haloperidol. There were no differences in weight gain between these three agents.

October 2020

Image: ©Jeff Baumgart –

Last updated at: 1:02 am, 31st August 2021
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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.