Psychotropic medication in the elderly

Abstract

Old age and disease are not synonymous. On the other hand elderly people spend more money on healthcare than any other group because they do tend to have more health problems than any other group of the population. The increasing elderly population may have resulted in an increased number of elderly patients requiring treatment for mental and behavioural disorders. Pfeiffer has concluded, through his own personal experience that 'in psychiatry, older patients are more responsive to treatment and intervention than any other age group .... but special considerations of changed circumstances - physiologic, psycho logic and social must be made in proceeding to diagnose, treat and hopefully rehabilitate'. Indeed, a disproportionately large percentage of psychotropic medications are prescribed to the elderly, many of whom believe that their daily performance depends on the use of these drugs. Moreover, there are relatively few clinical studies of the prescribing of psychotropic drugs, including sedatives, hypnotics, anxiolytics, antidepressants and neuroleptics in patients over 65 years of age, and also, few publications on the use of psychotropic drugs in the elderly. The appropriateness of psychotropic drug therapy begins with careful diagnosis which, in the elderly, should be directed at treating the underlying causes and problem rather than merely responding to symptoms.