In managing agitation in elderly patients, which drug is typically preferred due to its safety profile?

Lorazepam is often preferred in managing agitation in elderly patients because of its safety profile, particularly in the context of age-related pharmacokinetic and pharmacodynamic changes. In elderly patients, there's a heightened risk of adverse drug reactions, and lorazepam, being a benzodiazepine, is associated with a lower incidence of extrapyramidal side effects compared to typical antipsychotics like haloperidol.

Additionally, lorazepam has a relatively short half-life and is often effective for acute agitation without causing prolonged sedation. This is particularly crucial in elderly patients who may have comorbid conditions and may be more sensitive to the sedative effects of medications.

While atypical antipsychotics, such as olanzapine, can be utilized for agitation control, they carry a risk of side effects like metabolic syndrome and may also lead to extrapyramidal symptoms. Thus, lorazepam strikes a balance of efficacy in calming agitation while maintaining a safer profile for elderly patients.

Haloperidol, being a typical antipsychotic, is not favored due to its potential for causing significant neurological side effects, which can be particularly concerning in older adults.