Regarding the increase in the risk for pneumonia with the
use of typical and atypical antipsychotics in frail elderly
patients, several potential biologic explanations have been
hypothesized. However, the possible mechanisms of
antipsychotic-induced pneumonia remain speculative.
Aspiration is a well-known pathogenic mechanism for
CAP in elderly people, who are frequently affected by
swallowing disorders and decreased cough reflex [22, 23]. It
has been suggested that the use of typical antipsychotic drugs
may be a risk factor for aspiration pneumonia, as a result of
extrapyramidal effects [9••]. Blocking of dopamine receptors
may result in dyskinesia of the oral pharyngeal musculature,
rigidity, and spasm of the pharyngeal musculature, which can
result in dysphagia and ultimately in aspiration. Several case
reports of antipsychotic-induced dysphagia have been
described for both atypical and typical agents [24–30].
On the other hand, compared to typical agents, the risk