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Chapter 65. Treatment During Late Life

Steven P. Roose, M.D.; Bruce G. Pollock, M.D., Ph.D.; D. P. Devanand, M.D.
DOI: 10.1176/appi.books.9781585623860.443009

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Excerpt

Adverse events caused by medication have been estimated to be between the fourth and sixth leading cause of death in the United States (Lazarou et al. 1998). The elderly bear the greatest burden of medical illness and are subject to extensive medication regimens; in consequence, they experience more adverse drug events than do other segments of the population. In a large study of ambulatory Medicare enrollees, 38% of adverse drug events were serious, life-threatening, or fatal and 28% were considered preventable (Gurwitz et al. 2005). Moreover, psychotropics are among the most common medications associated with preventable adverse drug events in elderly patients in long-term care settings (Gurwitz et al. 2000).

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Table Reference Number
TABLE 65–1. Physiological changes in the elderly associated with altered pharmacokinetics

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A recent analysis of two large antidepressant treatment trials in late-life depression reported that patients with late-life depression
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