Geriatric psychopharmacology

Advancing age is associated with increased use of medication, with adults age 65 years and older consuming 30% of all prescription drugs and 40% of all nonprescription drugs (Dharmarajan & Ugalino, 2001). On average, older adults use three or more medications at any given time, with this polypharmacy associated with an increased incidence of adverse drug reactions (ADR). Other factors contributing to the increased incidence of ADR among older adults include age-related changes in pharmacokinetics and pharmacodynamics and a lack of dosing guidelines for elderly populations. Despite the increased use of medication and incidence of ADR among older adults, geriatric psychopharmacology has historically been a neglected area of medicine and research (Naranjo, Herrmann, Mittmann, & Bremner, 1995). This chapter reviews (a) the pharmacodynamics and pharmacokinetics of pharmacological treatment, (b) the pharmacological treatment of common geriatric disorders, (c) the side effects and neuropsychological consequences of compounds frequently used to treat the elderly, (d) the use of dietary supplements, and (e) polypharmacy considerations.