Epigenetic Alterations Impact on Antipsychotic Treatment in Elderly Patients

Bryan M. McClarty, Daniel W. Fisher, Hongxin Dong*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Purpose of the review: Antipsychotics are commonly prescribed for the treatment of psychosis as well as behavioral and psychological symptoms of dementia (BPSD) in elderly patients. However, elderly patients often experience decreased antipsychotic efficacy and increased side effects, though the mechanisms underlying these changes with age are not clear. Recent findings: Although aging can affect drug metabolism and clearance through changes in renal and hepatic function, additional pharmacokinetic and pharmacodynamic changes due to aging-induced epigenetic alterations also impact processes important for antipsychotic function. Epigenetic mechanisms account for some of the altered efficacy and increased side effects seen in elderly patients. Summary: Both clinical and animal studies from our group and others have demonstrated a plausible epigenetic mechanism involving histone modifications that can adversely affect the efficacy of antipsychotics and increase their side effects in elderly patients. Hopefully, further investigation of this mechanism will benefit elderly patients who need treatment for psychosis and BPSD.

Original languageEnglish (US)
Pages (from-to)17-29
Number of pages13
JournalCurrent Treatment Options in Psychiatry
Issue number1
StatePublished - Mar 1 2018


  • Aging
  • Antipsychotics
  • Drug efficacy
  • Epigenetics
  • Histone modification
  • Side effects

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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