Older Populations & Psych Medications
Key Considerations
- Adverse effects are 2-3 times higher in older adults, often related to polypharmacy.
- Older populations may be difficult to treat due to co-morbidities and variable clinical presentations.
- Medications and nutrient interactions may be impacted due to impaired appetite and pharmacokinetics; absorption, metabolism, distribution, and elimination.
- Initial dosing is half of the usual adult starting dose; start low, go slow.
- SSRI’s agent of choice (considered the safest of all antidepressants): escitalopram, citalopram, and sertraline best tolerated. Mirtazapine -wt. gain/sedation may be desirable. Buspirone is becoming more popular.
- Tardive dyskinesia is more prevalent in the elderly, all antipsychotics have Black Box Warning for dementia patients. Implement fall precautions.
Common Symptoms that Affect the Elderly
| CNS | sedation, confusion, disorientation, memory impairment, delirium |
| Cardiovascular | hypotension, orthostasis, cardiac conduction, abnormalities (arrhythmias, QTc prolongation) |
| Peripheral Anticholinergic Effects | constipation, dry mouth, blurred vision, urinary retention |
| Motor Effects | EPS, tremor, impaired gait, increased body sway, falling |
| Other | agitation, mood perceptual disturbances, headache, sexual dysfunction, GI (N/V, anorexia, appetite/bowel changes), metabolic, endocrine, electrolyte changes |
Learn about Memory Disorders and Resources
- American Geriatrics Healthcare Professionals: expanding the geriatrics knowledge base through disseminating basic, clinical, and health services research focused on the health of older people.
- All Americans—including people with disabilities and older adults—should be able to live at home with the support they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services (HHS) created the Administration for Community Living (ACL) in 2012.
- Free Emergency Cards & Emergency Kit for loved ones by Caregiverstress.com and find more downloads.
