These are considered to be due to age-related physiological changes.
Author: K. Ghose
Depression is one of the commonest problems in old age. Yet until recently, old people were systematically exduded from participating in drug trials and similar investigations. As a result, knowledge regarding incidence, natural history and management of depression in the elderly are somewhat limited. It is now well-established that old people are sensitive to most psychotropic drugs and they tend to suffer from adverse effects and side effects of antidepressant drugs more frequently than any other age group. These are considered to be due to age-related physiological changes. In addition, because of the frequent association with multiple pathology, the elderly are likely to receive polypharmacy which further complicates the management of antidepressant drug therapy. The aim of this book is to provide a comprehensive guidance on the drug therapy of depression for the dinicians involved in the health care of the elderly. In the first section, epidemiology, presentations and assessment of depression in old age and neuroendocrine abnormalities observed in patients with depression are briefly discussed. However, it mainly deals with the problems of antidepressant drug therapy, such as which antidepressant to prescribe, how to monitor efficacy and side effects, what is the adequate dose, how long to treat a single episode of depression and who requires long term medication. Information regarding pharmacology, side effects, adverse effects, drug interaction and pharmacokinetics of most currently available drugs are provided. Special emphasis has been given on continuation therapy and the choice of an antidepressant drug and their long term safety.
Mirtazapine lacks other antidepressant side effects such as cardiotoxicity or orthostatic hypotension . ... Unfortunately , because clinical trials of the newer antidepressants in elderly patients are brief in duration , lasting only 4 ...
Author: Carl Salzman
Publisher: Lippincott Williams & Wilkins
Thoroughly updated for its Fourth Edition, this volume is the most authoritative clinical reference on the pharmacologic treatment of psychiatric disorders in elderly patients. This edition provides complete information on new psychotropic drugs, new uses for established drugs, and clinically relevant advances in the neurosciences. Four new chapters cover genes, pharmacokinetics, and their impact on prescribing; new cognitive-enhancing strategies and drugs; late-life depression and physical illness; and depression and cardiac disease in late life. The book offers detailed guidelines—including drug names, dosages, and prescribing recommendations—for pharmacologic treatment of specific disorders. Chapters include clinical vignettes and tables presenting current clinical trial data. Appendices provide succinct information on prescribing and drug interactions.
Comprising a single repository of knowledge and scientific evidence in the field, this book provides strategies to mitigate fall risk by providing information on the complex interactions between aging processes, co-morbid conditions and ...
Author: Allen R. Huang
Comprising a single repository of knowledge and scientific evidence in the field, this book provides strategies to mitigate fall risk by providing information on the complex interactions between aging processes, co-morbid conditions and prescribed medications in older patients. Geriatric health is becoming a more prominent issue as the population ages, and balancing the beneficial effects of medication against the potential and real side-effects in these patients involves a deliberate and thoughtful task: physiologic aging, the accumulation of co-morbidities, and the use of drugs to manage various conditions and symptoms generates a unique set of problems for each patient. Falls are a dreaded event in older people. The event can affect a person in a physical, and psychological manner, resulting in soft tissue and bony injury, fear of falling, and depression. The identification of and reduction in fall risks in older people is a worldwide concern, and reducing the incidence of falls is a ubiquitous quality measure of health care delivery. Heterogeneity amongst older people precludes a single solution. However, physicians and others involved in the care of geriatric patients will benefit from the presented insights into how medication use can be modified to limit its impact as a contributing factor.
This book provides information about depression in the elderly to the staff in outpatient services and gives valuable advice for identification, diagnosis and treatment of the disorder.
Author: Robert Howard
Publisher: CRC Press
This book provides information about depression in the elderly to the staff in outpatient services and gives valuable advice for identification, diagnosis and treatment of the disorder. It is useful for general practitioners and other workers in the front line of medical care.
researchers in the United States because older adults have high demand for medications and they may be more ... use of antidepressant medications based on Beers' criteria among the elderly who used antidepressant at least once during ...
... antidepressants' in this chapter.) The selection of antidepressants for elderly patients is summarised in Table 3.7. ... Impact of screening old people with physical illness for depression? Lancet 2000; 356:91–92. 2 Lyketsos CG.
Author: David M. Taylor
Publisher: John Wiley & Sons
The revised 13th edition of the essential reference for the prescribing of drugs for patients with mental health disorders The revised and updated 13th edition of The Maudsley Prescribing Guidelines in Psychiatry provides up-to-date information, expert guidance on prescribing practice in mental health, including drug choice, treatment of adverse effects and how to augment or switch medications. The text covers a wide range of topics including pharmacological interventions for schizophrenia, bipolar disorder, depression and anxiety, and many other less common conditions. There is advice on prescribing in children and adolescents, in substance misuse and in special patient groups. This world-renowned guide has been written in concise terms by an expert team of psychiatrists and specialist pharmacists. The Guidelines help with complex prescribing problems and include information on prescribing psychotropic medications outside their licensed indications as well as potential interactions with other medications and substances such as alcohol, tobacco and caffeine. In addition, each of the book’s 165 sections features a full reference list so that evidence on which guidance is based can be readily accessed. This important text: Is the world’s leading clinical resource for evidence-based prescribing in day-to-day clinical practice and for formulating prescribing policy Includes referenced information on topics such as transferring from one medication to another, prescribing psychotropic medications during pregnancy or breastfeeding, and treating patients with comorbid physical conditions, including impaired renal or hepatic function. Presents guidance on complex clinical problems that may not be encountered routinely Written for psychiatrists, neuropharmacologists, pharmacists and clinical psychologists as well as nurses and medical trainees, The Maudsley Prescribing Guidelines in Psychiatry are the established reference source for ensuring the safe and effective use of medications for patients presenting with mental health problems.
Feinberg, M. (1993) The problems of anticholinergic adverse effects in older patients. Drugs Aging 3:335-348. Glassman, A.H. (1998) Cardiovascular effects of antidepressant drugs: Updated. J. Clin Psychiatry 59(suppl 15):13-18.
Author: Steven P. Roose M.D.
Publisher: Oxford University Press
We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60. This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this disorder. This book will be invaluable to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.
Age Elderly people Elderly people have high rates of depression but tend to be excluded from randomized trials of antidepressant treatment. In general, older people metabolize tricyclic antidepressants more slowly and have higher ...
Author: J. K. Aronson
"The unwanted effects of medications used in psychiatry can adversely affect a treatment plan. This volume will be critical in helping psychiatrists and mental health professionals assess the adverse effects of drugs such as antidepressants, mood stabilizers, hypnosedatives, and antipsychotic drugs." "This book summarizes the adverse effects of a large range of Psychiatric drugs. The material is drawn from the 15th edition of the internationally renowned encyclopedia, Meyler's Side Effects of Drugs: The Encyclopedia of Adverse Drug Reactions and Interactions, and the latest volumes in the companion series, Side Effects of Drugs Annuals."--BOOK JACKET.
In Chapter 8, Drs. Liptzin and Hobgood review the use of antidepressant medications in geriatric patients. After discussing the general principles of medication management in the older patient, the authors review age-specific side ...
Author: Anthony J. Rothschild
Publisher: American Psychiatric Pub
"The Evidence-Based Guide to Antipsychotic Medications" is a table-rich, comprehensive overview of current knowledge regarding the use of antipsychotic medications to treat a broad range of psychiatric conditions, from anxiety disorders to schizophrenia.
American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616–31. Gerson SC, Plotkin DA, Jarvik LF. Antidepressant drug studies, 1964 to 1986: empirical ...
Author: Francisco López-Muñoz
This work is a guidebook for clinicians who are involved in treating depressive patients and also serves the research scientists who are working on the psychopharmacological mechanisms of antidepressant actions and psychopathological mechanisms underlying mood disorders. Mood disorders such as major depressive disorder (MDD), bipolar disorder (BPD) and seasonal affective disorder (SAD) are the most disabling disorders that are among the most expensive of all medical illnesses. The pathophysiology of mood disorders is very complex and involves many mechanisms like circadian rhythm disruption, sleep abnormalities, melatonin rhythm abnormalities and alterations in melatonin receptor mechanisms, abnormalities in monoaminergic neurotransmitter mechanisms, glutamatergic release mechanisms, hippocampal neurogenesis, and abnormal immune and cytokine release mechanisms. Many antidepressants that are in clinical use today including the recently introduced novel agents like agomelatine or other antidepressants cause clinical remission by resynchronizing disrupted circadian rhythms and melatonin receptor functions, enhancing monoaminergic neurotransmission, promoting hippocampal neurogenesis, and regulating immune mechanisms. This book explains various etiological factors that are involved in the pathogenesis of mood disorders and the mechanisms of therapeutic actions of antidepressants including the recently introduced agomelatine and other antidepressants that exhibit rapid onset of action with greater efficacy and fewer side effects. .
Long term effect of depression care management on mortality in older adults: follow‐up of cluster randomized clinical trial in primary care. ... Antidepressants in elderly: metaregression of double‐blind, randomized clinical trials.
Author: David Taylor
Publisher: John Wiley & Sons
The essential reference for anyone responsible for prescribing drugs for patients with mental health disorders. Widely and regularly used: the place to check for all relevant information on which drugs to prescribe, which side effects to look out for, how best to augment or switch drugs, such as antipsychotics, antidepressants, and anxiolytics. The book provides brief but detailed reviews of psychiatric disorders and relevant psychopharmacology, with general guidance based on the data reviewed and current clinical practice. Sections cover plasma monitoring, schizophrenia, bipolar disorder, depression, anxiety, children and adolescents, substance abuse and special patient groups. Each section has a full reference list so that the evidence base can be checked quickly, if required. The book covers prescribing drugs outside their licensed indications and their interaction with substances such as alcohol, nicotine and caffeine. Trainees will gain important information regarding the rational, safe and effective use of medications for patients with mental illness. Experienced clinicians will find excellent guidance regarding more complex issues that they may not encounter regularly.
Side-effects of tri cyclic an ti d epressants of particular relevance in older patients Anticholinergic Confusion ... for newer antidepressants, most of which can be administered in the same dose to elderly as to younger patients.
Author: Alan Lee
Publisher: RCPsych Publications
Discusses the evidence-based assessment of deliberate self-harm, and covers the special problems of general psychiatric practice when alcohol misuse and severe personality disorder complicate the picture.
M.E. Tinetti, T.F. Williams & R. Mayewski, Fall risk index for elderly patients based on number of chronic disabilities. ... R. Ruthazer, L.A. Lipsitz, Antidepressants and falls among elderly people in long-term care.
Author: Stephen R. Lord
Publisher: Cambridge University Press
Since the first edition of this very successful book was written to synthesise and review the enormous body of work covering falls in older people, there has been an even greater wealth of informative and promising studies designed to increase our understanding of risk factors and prevention strategies. This second edition, first published in 2007, is written in three parts: epidemiology, strategies for prevention, and future research directions. New material includes recent studies covering: balance studies using tripping, slipping and stepping paradigms; sensitivity and depth perception visual risk factors; neurophysiological research on automatic or reflex balance activities; and the roles of syncope, vitamin D, cataract surgery, health and safety education, and exercise programs. This edition will be an invaluable update for clinicians, physiotherapists, occupational therapists, nurses, researchers, and all those working in community, hospital and residential or rehabilitation aged care settings.
In view of the multimorbidity and polypharmacy situations experienced by elderly patients, this book takes into account the special needs and requirements shown by this group, thus serving as a timely reference for physicians who treat the ...
Author: Martin Wehling
Publisher: Springer Science & Business Media
With people aged 65 years and older currently making up the fastest growing age group throughout the world, the demographic revolution of an aging society will inevitably lead to increased pressure to develop a rationalistic and age-tailored process of diagnosis and treatment among the elderly. As aging people often suffer from several chronic diseases and are being treated with multiple medications concurrently, unwanted drug interactions occur more frequently. Whereas recent approaches have recommended to remove particular drugs from the medication regimen to avoid adverse effects, Drug Therapy for the Elderly underlines both indispensable and dispensable elements of drug treatment in order to provide an overall assessment of drugs suitable for the aged. In view of the multimorbidity and polypharmacy situations experienced by elderly patients, this book takes into account the special needs and requirements shown by this group, thus serving as a timely reference for physicians who treat the elderly.
In an already depressed , anergic elderly person , sedation can be most unwelcome . Antidepressants , for example , amitriptyline and doxepin , also may increase sedation . Such sedation is sometimes experienced as increased depression ...
Release on 1996 | by United States. Congress. Senate. Special Committee on Aging
Most of the antidepressants are thought to be equally effective in elderly adults . The most commonly used and studied antidepressants have been nortriptyline and desipramine because they have a more favorable side effect spectrum than ...
Author: United States. Congress. Senate. Special Committee on Aging
Tricyclic antidepressants are older drugs with well - established efficacy . Older persons do best when given antidepressants with the least anticholinergic activity ; therefore , nortriptyline and desipramine are favored for older ...
Author: Joseph J. Gallo
Publisher: Lippincott Williams & Wilkins
Geared specifically for the family practitioner, this text provides clinical approaches to the whole geriatric patient. Topics covered in this fifth edition include behavioural disturbances in dementia, driving and the older adult, and clinical practice guidelines in the elderly.
The elderly may take longer to respond to antidepressants than younger adults3 and may require to be treated for longer periods overall . Flint and Rifat found that , of a cohort of elderly people who had recovered from a first episode ...
Author: David Taylor
Publisher: CRC Press
Now in its eighth edition, The Maudsley Prescribing Guidelines is the most widely used guide to psychiatric prescribing in the UK. Fully updated throughout, this new edition presents sections on topics of current interest such as antipsychotics and hyperlipidaemia, antipsychotic-induced hyponatraemia, borderline personality disorder, depression in multiple sclerosis, and melatonin for the treatment of insomnia in children and adolescents. Providing practically useful advice for common clinical situations, this is an essential text for prescribers, nursing staff, pharmacists, GPs, and those in related professions.
effects, neuroleptics are likely to cause tardive dyskinesia in the elderly. For most antidepressants, on the other hand, patients do best if the medication is within the therapeutic range regardless of age. Low-dose antidepressant ...
Author: Jan Busby-Whitehead
Publisher: Cambridge University Press
Category: Family & Relationships
A clinical guide for all health specialists offering practical, relevant and comprehensive information on managing the elderly patient.
Over-the- counter medications containing diphenhydramine and doxylamine used by older adults to improve sleep. ... Aguglia E, Serretti A. Antidepressants in elderly: metaregression of double-blind, randomized clinical trials.
Author: Pascual Ángel Gargiulo
Publisher: Springer Nature
This broad and thought-provoking volume provides an overview of recent intellectual and scientific advances that intersect psychiatry and neuroscience, offering a wide range of penetrating insights in both disciplines. The fourth volume on the topic in the last several years from a varying panel of international experts identifies the borders, trends and implications in both fields today and goes beyond that into related disciplines to seek out connections and influences. Similar to its three Update book predecessors, Psychiatry and Neuroscience – Volume IV presents a range of interesting topics in the main disciplines – psychiatry and neuroscience – and attempts to provide deeper comprehension or explication of the normal and diseased human mind, its biological correlates and its biographical and existential implications. This engaging volume continues the previous style of exploring different disciplines and trying to integrate disciplinary evidence from varying points of view in an organic manner. The first section is about epistemological considerations regarding the study of normal and abnormal human behaviors, including, for example, the topic of phenomenological psychopathology and phenomenological psychiatry in relation to schizophrenia and substance misuse, among other topics. Section 2 addresses issues around the translation of basic neuroscience to expression in the human brain and behavioral implications. Section 3 discusses the issues of learning, teaching and the role of social environment in the field of neuroscience. Finally section 4 reviews various perspectives on explaining human pathological behaviors -- from brain disorders to psychopathology.