Pharmacological treatment of psychiatric disorders of the elderly

ABSTRACT

Psychiatric disturbances in the elderly are complicated. Dementia and depression are serious causes of global impairment in the elderly. Aging is characterized by a progressive functional impairment of multiple organs, a reduction of homeostatic mechanisms, and a changed sensitivity or capacity of neurotransmitter receptors. Understanding the influence of age-dependent changes in the composition and function of the body on the pharmacokinetics and pharmacodynamics of drugs is important before prescribing drugs to elderly patients. However, there is little clinical pharmacological information available to guide pharmacotherapy for late-life psychiatric disorders. Treatment of dementia is based on the cognitive decline and behavioral symptoms that accompany dementia. Currently prescribed antidepressants have similar efficacies but the side effect profiles vary. Comprehension of the normal aging process and understanding the characteristics of each of the psychotropics are essential in geriatric psychopharmacology. Up to the present, most studies are confirmations or reproductions of previous results on efficacy or safety. Future directions for psychopharmacological research should include discovering newer drugs, treatment of resistance or nonresponders, and combination or adjunctive therapies. This review focused on the geriatric pharmacokinetic/pharmacodynamic changes and clinical information regarding currently prescribed psychotropic medications.