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Pharmacotherapy: Safe Prescribing and Adverse Drug Events

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Geriatric Psychiatry

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Abstract

Geriatric patients are likely to be treated with multiple medications for illnesses affecting many organ systems. The addition of psychotropic medication(s) to the regimens of patients already receiving many other medications must therefore be done only after consideration of the many factors that may affect safety and side effects. These factors include side effects attributable to psychotropic medications themselves, drug-drug interactions, and considerations of age-related changes in drug absorption, pharmacokinetics, and pharmacodynamics. This chapter addresses the issues of polypharmacy in geriatric patients and the specific central nervous system and systemic side effects that need to be actively considered when prescribing psychotropic medications to treat various psychiatric illnesses. Because geriatric patients often have multiple clinicians prescribing medications for multiple illnesses, communication among clinicians and active use of pharmacy profiling are recommended to facilitate safe medication prescribing and monitoring.

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Notes

  1. 1.

    The metabolic syndrome is defined as meeting at least three of the five criteria: abdominal obesity, hypertriglyceridemia, low high-density-lipoprotein cholesterol, hypertension, and a fasting blood glucose >100 mg/dL (5.55 mmol/L).

References

  1. American Geriatrics Society. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–94.

    Article  Google Scholar 

  2. O’Mahony D. STOPP/START criteria for potentially inappropriate medications/potential prescribing omissions in older people: origin and progress. Expert Rev Clin Pharmacol. 2020;13(1):15–22.

    Article  PubMed  Google Scholar 

  3. Egberts A, Moreno-Gonzalez R, Alan H, Ziere G, Mattace-Raso FUS. Anticholinergic drug burden and delirium: a systematic review. J Am Med Dir Assoc. 2021;22(1):65–73.e4.

    Article  PubMed  Google Scholar 

  4. Tormoehlen LM, Rusyniak DE. Neuroleptic malignant syndrome and serotonin syndrome. Handb Clin Neurol. 2018;157:663–75.

    Article  PubMed  Google Scholar 

  5. Edinoff AN, Ellis ED, Nussdorf LM, Hill TW, Cornett EM, Kaye AM, Kaye AD. Antipsychotic polypharmacy-related cardiovascular morbidity and mortality: a comprehensive review. Neurol Int. 2022;14(1):294–309.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–95.

    Article  PubMed  Google Scholar 

  7. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021;12(3):443–52.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Payne RA. The epidemiology of polypharmacy. Clin Med (Lond). 2016;16(5):465–9.

    Article  PubMed  Google Scholar 

  9. Hanlon JT, Pieper CF, Hajjar ER, Sloane RJ, Lindblad CI, Ruby CM, Schmader KE. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61(5):511–5.

    Article  PubMed  Google Scholar 

  10. Obreli Neto PR, Nobili A, de Lyra DP Jr, Pilger D, Guidoni CM, de Oliveira Baldoni A, et al. Incidence and predictors of adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study. J Pharm Pharm Sci. 2012;15(2):332–43.

    Article  CAS  PubMed  Google Scholar 

  11. Marcum ZA, Amuan ME, Hanlon JT, Aspinall SL, Handler SM, Ruby CM, Pugh MJ. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2012;60(1):34–41.

    Article  PubMed  Google Scholar 

  12. Parameswaran Nair N, Chalmers L, Peterson GM, Bereznicki BJ, Castelino RL, Bereznicki LR. Hospitalization in older patients due to adverse drug reactions—the need for a prediction tool. Clin Interv Aging. 2016;11:497–505.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Thorell K, Midlöv P, Fastbom J, Halling A. Importance of potentially inappropriate medications, number of chronic conditions and medications for the risk of hospitalisation in elderly in Sweden: a case-control study. BMJ Open. 2019;9(9):e029477.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Fahmi A, Wong D, Walker L, Buchan I, Pirmohamed M, Sharma A, et al. Combinations of medicines in patients with polypharmacy aged 65–100 in primary care: large variability in risks of adverse drug related and emergency hospital admissions. PLoS One. 2023;18(2):e0281466.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Hovstadius B, Hovstadius K, Astrand B, Petersson G. Increasing polypharmacy—an individual-based study of the Swedish population 2005–2008. BMC Clin Pharmacol. 2010;10:16.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Varghese D, Ishida C, Haseer Koya H. Polypharmacy. In: StatPearls. Treasure Island, FL: StatPearls Publishing LLC.; 2023.

    Google Scholar 

  17. Gerlach LB, Olfson M, Kales HC, Maust DT. Opioids and other central nervous system-active polypharmacy in older adults in the United States. J Am Geriatr Soc. 2017;65:2052.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Novaes PH, da Cruz DT, Lucchetti ALG, Leite ICG, Lucchetti G. The “iatrogenic triad”: polypharmacy, drug-drug interactions, and potentially inappropriate medications in older adults. Int J Clin Pharm. 2017;39:818.

    Article  CAS  PubMed  Google Scholar 

  19. Barnett ML, Song Z, Landon BE. Trends in physician referrals in the United States, 1999–2009. Arch Intern Med. 2012;172(2):163–70.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, et al. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr. 2019;19(1):277.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hirsch CH, Maharaj S, Bourgeois JA. The chief adverse effects of medications. In: Hategan A, Bourgeois JA, Hirsch CH, editors. On-call geriatric psychiatry: handbook of principles and practice. Switzerland: Springer Nature; 2016.

    Google Scholar 

  22. Wimmer BC, Cross AJ, Jokanovic N, Wiese MD, George J, Johnell K, et al. Clinical outcomes associated with medication regimen complexity in older people: a systematic review. J Am Geriatr Soc. 2017;65(4):747–53.

    Article  PubMed  Google Scholar 

  23. Gertz BJ, Holland SD, Kline WF, Matuszewski BK, Freeman A, Quan H, et al. Studies of the oral bioavailability of alendronate. Clin Pharmacol Ther. 1995;58(3):288–98.

    Article  CAS  PubMed  Google Scholar 

  24. Zijp IM, Korver O, Tijburg LB. Effect of tea and other dietary factors on iron absorption. Crit Rev Food Sci Nutr. 2000;40(5):371–98.

    Article  CAS  PubMed  Google Scholar 

  25. Preskorn S, Ereshefsky L, Chiu YY, Poola N, Loebel A. Effect of food on the pharmacokinetics of lurasidone: results of two randomized, open-label, crossover studies. Hum Psychopharmacol. 2013;28(5):495–505.

    Article  CAS  PubMed  Google Scholar 

  26. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact. 1987;5(2):67–9.

    CAS  PubMed  Google Scholar 

  27. Jung H, Peregrina AA, Rodriguez JM, Moreno-Esparza R. The influence of coffee with milk and tea with milk on the bioavailability of tetracycline. Biopharm Drug Dispos. 1997;18(5):459–63.

    Article  CAS  PubMed  Google Scholar 

  28. Chin TW, Loeb M, Fong IW. Effects of an acidic beverage (Coca-Cola) on absorption of ketoconazole. Antimicrob Agents Chemother. 1995;39(8):1671–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Eusebi LH, Rabitti S, Artesiani ML, Gelli D, Montagnani M, Zagari RM, Bazzoli F. Proton pump inhibitors: risks of long-term use. J Gastroenterol Hepatol. 2017;32:1295.

    Article  PubMed  Google Scholar 

  30. Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis. 2014;6(5):185–202.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Ahn N, Nolde M, Günter A, Güntner F, Gerlach R, Tauscher M, et al. Emulating a target trial of proton pump inhibitors and dementia risk using claims data. Eur J Neurol. 2022;29(5):1335–43.

    Article  PubMed  Google Scholar 

  32. Lee JW, Morris JK, Wald NJ. Grapefruit juice and statins. Am J Med. 2016;129(1):26–9.

    Article  CAS  PubMed  Google Scholar 

  33. Timbo BB, Ross MP, McCarthy PV, Lin CT. Dietary supplements in a national survey: prevalence of use and reports of adverse events. J Am Diet Assoc. 2006;106(12):1966–74.

    Article  CAS  PubMed  Google Scholar 

  34. Geller AI, Shehab N, Weidle NJ, Lovegrove MC, Wolpert BJ, Timbo BB, et al. Emergency department visits for adverse events related to dietary supplements. N Engl J Med. 2015;373(16):1531–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Di Minno A, Frigerio B, Spadarella G, Ravani A, Sansaro D, Amato M, et al. Old and new oral anticoagulants: food, herbal medicines and drug interactions. Blood Rev. 2017;31:193.

    Article  PubMed  Google Scholar 

  36. Gardiner P, Phillips R, Shaughnessy AF. Herbal and dietary supplement—drug interactions in patients with chronic illnesses. Am Fam Physician. 2008;77(1):73–8.

    PubMed  Google Scholar 

  37. Lund BC, Carnahan RM, Egge JA, Chrischilles EA, Kaboli PJ. Inappropriate prescribing predicts adverse drug events in older adults. Ann Pharmacother. 2010;44(6):957–63.

    Article  PubMed  Google Scholar 

  38. Ni Chroinin D, Neto HM, Xiao D, Sandhu A, Brazel C, Farnham N, et al. Potentially inappropriate medications (PIMs) in older hospital in-patients: prevalence, contribution to hospital admission and documentation of rationale for continuation. Australas J Ageing. 2016;35(4):262–5.

    Article  PubMed  Google Scholar 

  39. Hyttinen V, Jyrkka J, Valtonen H. A systematic review of the impact of potentially inappropriate medication on health care utilization and costs among older adults. Med Care. 2016;54(10):950–64.

    Article  PubMed  Google Scholar 

  40. American Geriarics Society. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052–81.

    Article  Google Scholar 

  41. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–8.

    Article  PubMed  Google Scholar 

  42. Ryan C, O’Mahony D, Kennedy J, Weedle P, Byrne S. Potentially inappropriate prescribing in an Irish elderly population in primary care. Br J Clin Pharmacol. 2009;68(6):936–47.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Blanco-Reina E, Garcia-Merino MR, Ocana-Riola R, Aguilar-Cano L, Valdellos J, Bellido-Estevez I, Ariza-Zafra G. Assessing potentially inappropriate prescribing in community-dwelling older patients using the updated version of STOPP-START criteria: a comparison of profiles and prevalences with respect to the original version. PLoS One. 2016;11(12):e0167586.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Hill-Taylor B, Walsh KA, Stewart S, Hayden J, Byrne S, Sketris IS. Effectiveness of the STOPP/START (Screening Tool of Older persons’ potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment) criteria: systematic review and meta-analysis of randomized controlled studies. J Clin Pharm Ther. 2016;41(2):158–69.

    Article  CAS  PubMed  Google Scholar 

  45. Alagiakrishnan K, Ballermann M, Rolfson D, Mohindra K, Sadowski CA, Ausford A, et al. Utilization of computerized clinical decision support for potentially inappropriate medications. Clin Interv Aging. 2019;14:753–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. GeriatricsCareOnline.org. AGS Beers Criteria mobile app. American Geriatrics Society; 2023.

    Google Scholar 

  47. GeriatricsCareOnline.org. AGS Beers Criteria pocketcard. American Geriatrics Society; 2023.

    Google Scholar 

  48. Lisibach A, Benelli V, Ceppi MG, Waldner-Knogler K, Csajka C, Lutters M. Quality of anticholinergic burden scales and their impact on clinical outcomes: a systematic review. Eur J Clin Pharmacol. 2021;77(2):147–62.

    Article  PubMed  Google Scholar 

  49. West T, Pruchnicki MC, Porter K, Emptage R. Evaluation of anticholinergic burden of medications in older adults. J Am Pharm Assoc. 2013;53(5):496–504.

    Article  Google Scholar 

  50. Beuscart JB, Dupont C, Defebvre MM, Puisieux F. Potentially inappropriate medications (PIMs) and anticholinergic levels in the elderly: a population based study in a French region. Arch Gerontol Geriatr. 2014;59(3):630–5.

    Article  PubMed  Google Scholar 

  51. Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015;15:31.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Zheng YB, Shi L, Zhu XM, Bao YP, Bai LJ, Li JQ, et al. Anticholinergic drugs and the risk of dementia: a systematic review and meta-analysis. Neurosci Biobehav Rev. 2021;127:296–306.

    Article  CAS  PubMed  Google Scholar 

  53. Chatterjee S, Bali V, Carnahan RM, Johnson ML, Chen H, Aparasu RR. Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression. Am J Geriatr Psychiatry. 2016;24(6):485–95.

    Article  PubMed  Google Scholar 

  54. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Jeon WJ, Dean B, Scarr E, Gibbons A. The role of muscarinic receptors in the pathophysiology of mood disorders: a potential novel treatment? Curr Neuropharmacol. 2015;13(6):739–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008;168(5):508–13.

    Article  PubMed  Google Scholar 

  57. Stewart C, Taylor-Rowan M, Soiza RL, Quinn TJ, Loke YK, Myint PK. Anticholinergic burden measures and older people’s falls risk: a systematic prognostic review. Ther Adv Drug Saf. 2021;12:20420986211016645.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR. The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol. 2006;46(12):1481–6.

    Article  CAS  PubMed  Google Scholar 

  59. Lampela P, Lavikainen P, Garcia-Horsman JA, Bell JS, Huupponen R, Hartikainen S. Anticholinergic drug use, serum anticholinergic activity, and adverse drug events among older people: a population-based study. Drugs Aging. 2013;30(5):321–30.

    Article  CAS  PubMed  Google Scholar 

  60. Magin PJ, Morgan S, Tapley A, McCowan C, Parkinson L, Henderson KM, et al. Anticholinergic medicines in an older primary care population: a cross-sectional analysis of medicines’ levels of anticholinergic activity and clinical indications. J Clin Pharm Ther. 2016;41(5):486–92.

    Article  CAS  PubMed  Google Scholar 

  61. Bloch F, Thibaud M, Dugue B, Breque C, Rigaud AS, Kemoun G. Psychotropic drugs and falls in the elderly people: updated literature review and meta-analysis. J Aging Health. 2011;23(2):329–46.

    Article  PubMed  Google Scholar 

  62. Lin SM, Borges MK, de Siqueira ASS, Biella MM, Jacob-Filho W, Cesari M, et al. Serotonin receptor inhibitor is associated with falls independent of frailty in older adults. Aging Ment Health. 2021;25(2):219–24.

    Article  PubMed  Google Scholar 

  63. AFFINITY Trial Collaboration. Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2020;19(8):651–60.

    Article  Google Scholar 

  64. Gebara MA, Lipsey KL, Karp JF, Nash MC, Iaboni A, Lenze EJ. Cause or effect? Selective serotonin reuptake inhibitors and falls in older adults: a systematic review. Am J Geriatr Psychiatry. 2015;23(10):1016–28.

    Article  PubMed  Google Scholar 

  65. Iaboni A, Flint AJ. The complex interplay of depression and falls in older adults: a clinical review. Am J Geriatr Psychiatry. 2013;21(5):484–92.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Lenze EJ, Rogers JC, Martire LM, Mulsant BH, Rollman BL, Dew MA, et al. The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. Am J Geriatr Psychiatry. 2001;9(2):113–35.

    Article  CAS  PubMed  Google Scholar 

  67. Marcum ZA, Perera S, Thorpe JM, Switzer GE, Castle NG, Strotmeyer ES, et al. Antidepressant use and recurrent falls in community-dwelling older adults: findings from the health ABC Study. Ann Pharmacother. 2016;50(7):525–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Erickson SC, Le L, Zakharyan A, Stockl KM, Harada AS, Borson S, et al. New-onset treatment-dependent diabetes mellitus and hyperlipidemia associated with atypical antipsychotic use in older adults without schizophrenia or bipolar disorder. J Am Geriatr Soc. 2012;60(3):474–9.

    Article  PubMed  Google Scholar 

  69. Ramaswamy K, Masand PS, Nasrallah HA. Do certain atypical antipsychotics increase the risk of diabetes? A critical review of 17 pharmacoepidemiologic studies. Ann Clin Psychiatry. 2006;18(3):183–94.

    Article  PubMed  Google Scholar 

  70. Lipscombe LL, Levesque LE, Gruneir A, Fischer HD, Juurlink DN, Gill SS, et al. Antipsychotic drugs and the risk of hyperglycemia in older adults without diabetes: a population-based observational study. Am J Geriatr Psychiatry. 2011;19(12):1026–33.

    Article  PubMed  Google Scholar 

  71. Bishara A, Phan SV, Young HN, Liao TV. Glucose disturbances and atypical antipsychotic use in the intensive care unit. J Pharm Pract. 2015;29:534.

    Article  PubMed  Google Scholar 

  72. DeJongh BM. Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome. Ment Health Clin. 2021;11(6):311–9.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ (Clin Res ed). 2011;343:d4551.

    Article  Google Scholar 

  74. De Picker L, Van Den Eede F, Dumont G, Moorkens G, Sabbe BG. Antidepressants and the risk of hyponatremia: a class-by-class review of literature. Psychosomatics. 2014;55(6):536–47.

    Article  PubMed  Google Scholar 

  75. Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008;52(1):144–53.

    Article  CAS  PubMed  Google Scholar 

  76. Bhuvaneswar CG, Baldessarini RJ, Harsh VL, Alpert JE. Adverse endocrine and metabolic effects of psychotropic drugs: selective clinical review. CNS Drugs. 2009;23(12):1003–21.

    Article  CAS  PubMed  Google Scholar 

  77. Lazarus JH. Lithium and thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23(6):723–33.

    Article  CAS  PubMed  Google Scholar 

  78. Mifsud S, Cilia K, Mifsud EL, Gruppetta M. Lithium-associated hyperparathyroidism. Br J Hosp Med (Lond). 2020;81(11):1–9.

    Article  PubMed  Google Scholar 

  79. Niethammer M, Ford B. Permanent lithium-induced cerebellar toxicity: three cases and review of literature. Mov Disord. 2007;22(4):570–3.

    Article  PubMed  Google Scholar 

  80. Juurlink DN, Mamdani MM, Kopp A, Rochon PA, Shulman KI, Redelmeier DA. Drug-induced lithium toxicity in the elderly: a population-based study. J Am Geriatr Soc. 2004;52(5):794–8.

    Article  PubMed  Google Scholar 

  81. Perry PJ, Wilborn CA. Serotonin syndrome vs neuroleptic malignant syndrome: a contrast of causes, diagnoses, and management. Ann Clin Psychiatry. 2012;24(2):155–62.

    PubMed  Google Scholar 

  82. Abadie D, Rousseau V, Logerot S, Cottin J, Montastruc JL, Montastruc F. Serotonin syndrome: analysis of cases registered in the French Pharmacovigilance Database. J Clin Psychopharmacol. 2015;35(4):382–8.

    Article  CAS  PubMed  Google Scholar 

  83. Jhun P, Bright A, Herbert M. Serotonin syndrome and opioids—what’s the deal? Ann Emerg Med. 2015;65(4):434–5.

    Article  PubMed  Google Scholar 

  84. Douros A, Grabowksi K, Stahlmann R. Drug-drug interactions and safety of linezolid, tedizolid, and other oxazolidinones. Expert Opin Drug Metab Toxicol. 2015;11:1849–59.

    Article  CAS  PubMed  Google Scholar 

  85. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005;352(11):1112–20.

    Article  CAS  PubMed  Google Scholar 

  86. Deardorff OG, Khan T, Kulkarni G, Doisy R, Loehr C. Serotonin syndrome: prophylactic treatment with cyproheptadine. Prim Care Companion CNS Disord. 2016;18(4) https://doi.org/10.4088/PCC.16br01966.

  87. Takeuchi H, Suzuki T, Remington G, Uchida H. Antipsychotic polypharmacy and corrected QT interval: a systematic review. Can J Psychiatry. 2015;60(5):215–22.

    Article  PubMed  PubMed Central  Google Scholar 

  88. de Abajo FJ. Effects of selective serotonin reuptake inhibitors on platelet function: mechanisms, clinical outcomes and implications for use in elderly patients. Drugs Aging. 2011;28(5):345–67.

    Article  PubMed  Google Scholar 

  89. Jiang HY, Chen HZ, Hu XJ, Yu ZH, Yang W, Deng M, et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2015;13(1):42–50.e3.

    Article  CAS  PubMed  Google Scholar 

  90. Shin D, Oh YH, Eom CS, Park SM. Use of selective serotonin reuptake inhibitors and risk of stroke: a systematic review and meta-analysis. J Neurol. 2014;261(4):686–95.

    Article  CAS  PubMed  Google Scholar 

  91. Ouellet GM, Ouellet JA, Tinetti ME. Principle of rational prescribing and deprescribing in older adults with multiple chronic conditions. Ther Adv Drug Saf. 2018;9(11):639–52.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Reeve E, Wolff JL, Skehan M, Bayliss EA, Hilmer SN, Boyd CM. Assessment of attitudes toward deprescribing in older Medicare beneficiaries in the United States. JAMA Intern Med. 2018;178(12):1673–80.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Bloomfield HE, Greer N, Linsky AM, Bolduc J, Naidl T, Vardeny O, et al. Deprescribing for community-dwelling older adults: a systematic review and meta-analysis. J Gen Intern Med. 2020;35(11):3323–32.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Thillainadesan J, Gnjidic D, Green S, Hilmer SN. Impact of deprescribing interventions in older hospitalised patients on prescribing and clinical outcomes: a systematic review of randomised trials. Drugs Aging. 2018;35(4):303–19.

    Article  CAS  PubMed  Google Scholar 

  95. Vasilevskis EE, Shah AS, Hollingsworth EK, Shotwell MS, Kripalani S, Mixon AS, Simmons SF. Deprescribing medications among older adults from end of hospitalization through postacute care: a shed-MEDS randomized clinical trial. JAMA Intern Med. 2023;183(3):223–31.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Adams EN, Marks A, Lizer MH. Carbamazepine-induced hyperammonemia. Am J Health Syst Pharm. 2009;66(16):1468–70.

    Article  PubMed  Google Scholar 

  97. Wu YF. Recurrent hyperammonemia associated with olanzapine. J Clin Psychopharmacol. 2017;37(3):366–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  2. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Shyam Maharaj

  3. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    James A. Bourgeois

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  1. Calvin H. Hirsch
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  2. Shyam Maharaj
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  3. James A. Bourgeois
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Correspondence to Calvin H. Hirsch .

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Editors and Affiliations

  1. Division of Geriatric Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    Caroline Giroux

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Hirsch, C.H., Maharaj, S., Bourgeois, J.A. (2024). Pharmacotherapy: Safe Prescribing and Adverse Drug Events. In: Hategan, A., Bourgeois, J.A., Hirsch, C.H., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-47802-4_5

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