Antipsychotic agents can be useful in the treatment of elderly patients who manifest psychotic signs and symptoms. Geropsychiatric disorders in which these drugs may be indicated include chronic schizophrenia persisting into late life, paraphrenia, dementia, and delirium. Unfortunately, antipsychotic drugs are more difficult to use in elderly patients than in younger psychotic patients. A clearly positive clinical response is less likely to occur in elderly patients, particularly in those who have an underlying dementia. In addition, the incidence of adverse effects in elderly patients is high. However, if these cautions are kept in mind, the clinician can select the appropriate antipsychotic based on a patient's particular medical status and, thus, reduce the patient's disability and enhance the patient's quality of life.