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It is important to be aware of potential risks and safety concerns associated with the use of this medication, particularly in specific populations. Below, we outline critical information to ensure safe use and highlight precautions that should be taken:

• Increased Risk for Older Adults with Dementia: There is a heightened risk of severe, potentially fatal side effects, including stroke, heart failure, irregular heartbeat, and pneumonia, when this medication is administered to older adults with dementia. Studies indicate an increased likelihood of death in these individuals, often due to heart-related issues or infections. Therefore, Nuplazid (pimavanserin) should not be used for treating hallucinations or delusions in dementia-related psychosis. Discuss the potential risks and benefits with your healthcare provider if you or a loved one with dementia is being considered for this treatment.

• Life-Threatening Heart Rhythm Changes (QT Prolongation): This medication can cause prolongation of the QT interval, which affects how your heart contracts and relaxes. This condition can lead to severe heart rhythm abnormalities that could be life-threatening. Individuals with a history of irregular heart rhythms, inherited heart rhythm disorders, a slow heart rate, or low levels of potassium or magnesium should exercise caution. Additionally, concurrent use of other medications affecting heart rhythm may elevate the risk.

• Consult with Healthcare Providers: It is crucial to have a thorough discussion with your healthcare provider regarding these risks, particularly if you belong to a high-risk group. Always inform your doctor about any pre-existing conditions or other medications you are taking.

In case of an overdose or emergency, immediate medical attention should be sought. Keep this information in mind to ensure a safe treatment experience.

When taking this medication, some individuals may experience common side effects, such as swelling in the arms, legs, or feet, nausea, confusion, hallucinations, and constipation. These effects are generally mild and should improve over time. However, if they persist or worsen, it is advisable to consult your healthcare provider for further guidance.

In addition to the common side effects, other reactions have been reported, including abnormal walking, sleepiness, falls, rash, hives, agitation or distress, and aggression. While these are not as common, it is important to monitor your symptoms and seek medical advice if they become concerning or severe.

There are also rare but serious side effects that require immediate medical attention. These include abnormal heart rhythms, such as a racing or pounding heart, severe dizziness, fainting, or signs of angioedema, which involve swelling of the face, lips, tongue, or throat, and difficulty breathing. If you experience any of these symptoms, it is crucial to seek urgent medical care.

Although a severe allergic reaction to this medication is uncommon, be aware of symptoms such as a rash, severe dizziness, itching, swelling, and trouble breathing. Prompt medical attention is necessary in these cases. Always communicate any unexpected effects to your healthcare provider to ensure your safety and well-being.