Drug-induced seizures in the elderly. Causative agents and optimal management.

We conducted a review of drugs that were most commonly associated with inducing seizures in the elderly population. The method for determining the risk of these agents includes evaluating the utilisation and the percentage of adverse events in previous studies and case reports. Classes of medications, such as anti-psychotics and antidepressants, are extensively reviewed to provide the clinician with treatment options in high risk patients. The risk of seizures secondary to the withdrawal of alcohol (ethanol) and benzodiazepines, and methods employed to minimise the risk are discussed. In addition, the management of patients with drug-induced seizures is delineated. Drug-induced seizures are a potentially serious adverse effect. It is important that clinicians are aware of which classes of medications and individual medications are associated with reducing seizure threshold.

Autonomy and care for the frail elderly. A one-year project identifies effective interventions for congregate housing residents.

In 1989 the St. Louis-based Cardinal Ritter Institute (CRI) conducted a demonstration project to determine how effective its interventions were in enabling the elderly to age in place. Preliminary screenings of persons at a congregate living site for the elderly revealed four major areas of concern: deficient knowledge of medication regimens, side effects, and purposes; need for basic social interaction; depression-related primarily to loneliness and isolation; insufficient knowledge of community resources. A multifaceted program developed by CRI staff helped alleviate many of these problems. The program's success shows that early identification of frail elderly at risk for losing their independence can guide interventions that allow them to age in place.

Substance abuse in older women.

Literature on elderly women and substance abuse is sparse. What data exist support the following conclusions: (1) older women are at risk for self-medicating with prescription drugs and alcohol and have more risk for drug-drug and drug-alcohol interactions, (2) women are more likely to be prescribed psychotropics, (3) older women are at greater risk for prescription drug abuse by a physician or physicians than other age groups, (4) alcohol and drug abuse are likely to increase as younger women drinkers and drug users age, and this younger cohort will use more illicit drugs, and (5) the incidence of substance abuse remains underreported and underdiagnosed.