Practical issues in geriatric psychopharmacology.

ABSTRACT

In summary, clinicians must consider multiple changes in the absorption, distribution, metabolism, and elimination of psychotropic drugs among older patients. Lower starting doses (often one-quarter to one-half the usual adult dose) is advisable, with slow dosing adjustments (no sooner than every 5 to 7 days) as needed. The time required to see steady-state therapeutic levels, or for elimination of most medications, are substantially longer in the elderly. One must consider the potential for drug-drug interactions, as well as anti-cholinergic or other side-effects, when prescribing a regimen. Changes should be made slowly, changing only one variable at a time, in order to achieve best results.