Conclusions
Antipsychotic-associated CAP (probably aspiration pneumonia)
seems to be a clinically relevant issue in frail elderly
patients, as consistently documented in several epidemiologic
investigations. No clear evidence exists for an increased risk
of pneumonia in younger patients treated with antipsychotics.
In elderly populations, the increase in risk is dose-dependent,
and is more pronounced in the early phases of treatment with
either typical or atypical antipsychotics.
On the basis of significant differences in the receptor
binding profile of individual antipsychotics, heterogeneity in
the risk for pneumonia among various compounds is
suggested. Extrapyramidal adverse events, sedation, and
dysphagia as a result of the antipsychotic action at dopamine,
H1 receptors, and cholinergic receptors, are risk factors that
may all play a role in antipsychotic-induced pneumonia.
Future studies should better define the mechanism underlying
antipsychotic-induced pneumonia and identify subgroups of
antipsychotic users at higher risk of developing pneumonia