Special Considerations for the Elderly
Prescribing psychotropic medication for 85-year-olds is more challenging than in younger adults. Due to age-related changes in hepatic metabolism and renal excretion, older adults may require 1/2 to 1/3 the dose of medications that younger adults may need to see therapeutic benefits. Older adults are also more likely to be on several prescriptions and over-the-counter medications – hence, the risk of drug-drug interactions is greater. Lastly, older adults are more sensitive to common side effects of medications, even at low doses. The American Society of Consultant Pharmacists has adopted the saying that “any symptom in an elderly patient should be considered a drug side-effect until proven otherwise.” They are particularly sensitive to sedating and cognitive-impairing side effects of commonly prescribed agents. It is important for clinicians to be familiar with the Beers Criteria or Beers List of so-called good drugs and bad drugs in the elderly.
KeywordsPsychotropic medication in the elderly Falls in the elderly and psychotropic medication Drug-drug interactions in the elderly Psycho-pharmacotherapy in the elderly Drug metabolism in the elderly
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