Resumen de Prescribed Psychotropic Drugs in the Elderly
As people grow older, side effects due to the modification of pharmacokinetics are the main disadvantage in the use of psychotropic drugs in geriatrics. This is why it is important to know the large variations of the pharmacokinetic parameters in the elderly subject. The main modifications are related with kidney functions. However, aging can alter the sensitivity of central nervous system receptors, mainly dopaminergic receptors.Anxiety should be treated mainly with selective serotonin reuptake inhibitors (SSRIs) taking great care as to the doses. Hypnotics used are mainly benzodiazepines or Z- drugs which are benzodiazepine-like drugs, which must be prescribed carefully considering the risk of sedation during the day and falls during night. Regarding depression, all the tricyclics and tetracyclics can be used, not forgetting the atropinic effects they have. SSRIs have not yet demonstrated their efficacy in treating depression in the elderly. Mood stabilizers such as lithium, carbamazepine, and valproate could be used with the same limitations as those in adults. Antipsychotics will get best used in confused or delirious states: their main side effects are of extrapyramidal nature but haloperidol using low doses could be of interest in behavioral symptoms linked to old age.
