Psychopharmacology: Introduction | Antidepressant Medications | Psychostimulants | Antipsychotic Medications | Mood Stabilizers | Anticonvulsants | Anxiolytics and Hypnotics | Cognitive Enhancers | Key Points | References | Suggested Readings
Pharmacological intervention in late life requires special
care. Elderly patients are more susceptible to drug-induced adverse
events. Particularly troublesome among older persons are peripheral
and central anticholinergic effects such as constipation, urinary retention,
delirium, and cognitive dysfunction; antihistaminergic effects such
as sedation; and antiadrenergic effects such as postural hypotension.
Sedation and orthostatic hypotension not only interfere with basic
activities but also pose a significant safety risk to elderly patients
because they can lead to falls and fractures. Increased susceptibility
to adverse effects in elders may be a result of the pharmacokinetic
and pharmacodynamic changes associated with aging, such as diminished
glomerular filtration, changes in the density and activity of target
receptors, reduced liver size and hepatic blood flow, and decreased
cardiac output (Lotrich and Pollock 2005) (Table 26–1).