Which antipsychotic is listed for dementia with Alzheimer-type psychosis?

• A. Clozapine
• B. Haloperidol
• C. Quetiapine
• D. Olanzapine

Answer: (D)

When treating psychosis in dementia, especially Alzheimer-type dementia, clinicians look for antipsychotics that manage delusions and agitation while minimizing movement-related side effects in older adults. Olanzapine is a second-generation antipsychotic that often appears on drug lists for dementia-related psychosis because it can address psychotic symptoms with a lower risk of extrapyramidal symptoms than a typical antipsychotic like haloperidol. It also provides sedative effects that can help with agitation, which is common in these patients. However, all antipsychotics carry safety concerns in the elderly with dementia, including increased mortality risk and metabolic or sedative effects, so use is cautious and monitored. In contrast, haloperidol carries more movement-related risks, clozapine requires strict blood monitoring and is typically for refractory schizophrenia, and quetiapine, while used for agitation, may not be as effective for core psychosis. Therefore, olanzapine fits best as a listed option for dementia with Alzheimer-type psychosis.