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Clinical Problems in Treating the Aged With Psychotropic Drugs

  • John M. Davis
  • William E. Fann
  • M. Khaled El-Yousef
  • David S. Janowsky
Part of the Advances in Behavioral Biology book series (ABBI, volume 6)

Abstract

The purpose of this paper is to review the use of psychotropic drugs in the aged. Psychotropic agents can be an effective tool in a physician’s armamentarium in treating mental disorders in the aged. However, these drugs can also be inappropriately used. The aged may be more susceptible to certain drug side effects. In addition, since they are more apt to have medical problems, there is more likelihood of drug-drug interactions occurring. Even physicians who may not be particularly interested in psychotropic drug use may need to be knowledgeable about this aspect of patient care since patients may suffer from toxicity due to psychotropic drugs administered by another physician or by the patients themselves. Psychotropic drugs are commonly taken by a large percentage of the population of the United States (Balter and Levine, 1971). Two hundred twenty million prescriptions are filled by patients for psychotropic drugs; 80 million for antianxiety agents; 40 million for hypnotics; 30 million for stimulants. Patients can often be taking several psychotropic drugs, sometimes administered by one physician, sometimes administered by several different physicians with the patient continuing to take one doctor’s prescription as well as a second psychotropic agent added by another doctor. To this cocktail can be added proprietary medications bought without prescription. Since sedative hypnotics do reduce mental function, it is not unusual to find elderly patients who are over-medicated who may do better when they discontinue the cocktail of sedative hypnotic drugs which they are taking. For that reason, the first problem in treating the aged with psychotropic drugs is for the clinician to consider whether the patient needs the psychotropic drugs he may be on. The discontinuance of current medication to get a drug-free baseline state is a useful strategy for the treatment of many patients. It is important to evaluate the patient’s medical status and use of the wide variety of drugs for treating his medical problems. This information is relevant to drug-drug interactions and side effects of possible psychotropic drugs. Having reviewed the patient’s baseline status and his medical problems, one may move on to consider which psychotropic drugs may be indicated for a given patient.

Keywords

Psychotropic Drug Geriatric Patient Ergot Alkaloid Confusional State Antiparkinsonian Drug 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Plenum Press, New York 1973

Authors and Affiliations

  • John M. Davis
  • William E. Fann
  • M. Khaled El-Yousef
  • David S. Janowsky

There are no affiliations available

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