Pharmacological Interventions in Older Adults

  • Jay J. PatelEmail author
  • Dale W. Smith
  • John Heafner
  • Christopher NG
  • George T. Grossberg


In this chapter, we discuss the different pharmacological interventions for psychiatric diseases in the geriatric population. We specifically divide these treatments into five categories: anxiolytics and sedative-hypnotics, antipsychotics, antidepressants, mood stabilizers, and cognitive enhancers. These categories are further divided into disease-specific medications. The utility, general recommendations, mechanism of action, dosing, and adverse reactions of drugs are covered for the medications in this chapter. The treatment of mental illness in the geriatric population is a complicated process due to the physiologic changes of metabolism, drug absorption, and drug excretion. These transformations specifically alter the dosing of pharmacological treatments in older adults. The shift in metabolism inherently changes the side effect profile of medications compared to the general adult population, which further complicates the utilization of pharmaceutical interventions for older adults with psychiatric conditions. It is our goal to provide a solid background for clinicians to make prudent decisions in the treatment approach of psychiatric diseases in the geriatric population.


Adverse reactions of mood stabilizers Antidepressants for older adults Antipsychotics for older adults Anxiolytics for older adults Cholinesterase inhibitors Cognitive enhancers in older adults Lithium for older adults Mood stabilizers for older adults NMDA in older adults Non-benzodiazepines for older adults SIADH in older adults SSRIs for older adults 



Angiotensin-converting enzyme


Alzheimer’s disease


Alzheimer’s disease cooperative study/activities of daily living inventory score


Activities of daily living


Antiepileptic drug


American Psychiatric Association


Bristol Activities of Daily Living score


Blood urea nitrogen




Complete blood count


Cognitive behavioral therapy


Chronic kidney disease


Central nervous system




Electro-compulsive therapy


Glomerular filtration rate


Gamma-aminobutyric acid


Generalized anxiety disorder


Global impression score


Hamilton Depression Rating Scale score


Human immunodeficiency virus


Liver function test


Montgomery Asberg Depression Rating Scale


Monoamine oxidase inhibitor


Mini mental status exam


Major neurocognitive disorder




Neuropsychiatric inventory


Obsessive compulsive disorder


Obstructive sleep apnea


Post-traumatic stress disorder


Social avoidance and distress scale


Syndrome of inappropriate antidiuretic hormone secretion


Severe impairment battery scale


Steven-Johnson syndrome


Serotonin-norepinephrine reuptake inhibitor


Selective serotonin reuptake inhibitor


Selective serotonin reuptake inhibitors


Tricyclic antidepressant


Toxic epidermal necrolysis syndrome


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jay J. Patel
    • 1
    Email author
  • Dale W. Smith
    • 1
  • John Heafner
    • 1
  • Christopher NG
    • 1
  • George T. Grossberg
    • 2
  1. 1.Department of Neurology and Behavioral NeuroscienceSaint Louis University School of MedicineSt. LouisUSA
  2. 2.Department of Psychiatry and Behavioral NeuroscienceSaint Louis University School of MedicineSt. LouisUSA

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