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Psychiatry and Neuroscience Update pp 647–660Cite as

Prescribed Psychotropic Drugs in the Elderly

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Abstract

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.

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Authors and Affiliations

  1. Neurobiology of Anxiety and Mood Disorder, Faculty of Medicine, University of Nantes, Nantes, France

    Michel Bourin

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  1. Laboratory of Neurosciences and Experimental Psychology Latin American Technological Corporation Foundation (FUCOTEL) Cathedra of Psychopathology, Catholic University of Argentina Area of Pharmacology Department of Pathology, National University of Cuyo CONICET, Guaymallén, Mendoza, Argentina

    Pascual Ángel Gargiulo

  2. National Academy of Medicine, Buenos Aires, Argentina

    Humberto Luis Mesones Arroyo

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Bourin, M. (2021). Prescribed Psychotropic Drugs in the Elderly. In: Gargiulo, P.Á., Mesones Arroyo, H.L. (eds) Psychiatry and Neuroscience Update. Springer, Cham. https://doi.org/10.1007/978-3-030-61721-9_46

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