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Psychotropic Medication Use in the Elderly

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Psychiatry and Neuroscience Update - Vol. II

Abstract

Aging is associated with progressive decrease in the function of multiple organs, presence of comorbidities, polypharmacy, and functional and social problems that may lead to inappropriate use of drugs. Consequently, the elderly are very vulnerable to display adverse reactions, interactions, hospitalizations, mortality, and poor adherence to treatment. The most serious side-effects in the elderly are caused by antiplatelet agents, diuretics, anticoagulants, and non-steroidal anti-inflammatory drugs; and within psychotropic drugs, benzodiazepines, antidepressants, and antipsychotic medications are of high risk. Anxiolytics produce excessive sedation, decreased alertness, confusion, ataxia, falls and hip fractures, increased mortality, and impairment of dementia symptoms. Antidepressants may lead to lack of response to treatment and anticholinergic effects. Antipsychotics may produce limited benefit and stroke. A deeply rooted cultural problem in the West is to see old age as synonymous of illness, the elderly being inevitably favorite targets of medicalization, particularly with psychotropic drugs. Problems of everyday life such as sadness or anxiety have become diseases that can be treated with anxiolytics or antidepressants. Psychotropic drugs relieve symptoms that produce certain diseases; if they are used for another purpose, this is considered inappropriate use. Health professionals should contribute by: reducing excessive and unnecessary consumption of psychotropic drugs, promoting their de-prescription, encouraging patients to face their difficulties without drugs, and searching for other solutions such as adoption of hygienic–sanitary measures, reducing risks to patient health, and reducing health costs. For these reasons, our objective is to describe some aspects related to the use of psychotropic drugs in the elderly, suggesting possible measures to improve it.

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References

  1. Elliott RA. Problems with medication use in the elderly: an Australian perspective. J Pharm Pract Res. 2006;36:58–66.

    Article  Google Scholar 

  2. Shah BM, Hajjar ER. Polypharmacy, adverse drug reactions, and geriatric syndromes. Clin Geriatr Med. 2012;28:173–86.

    Article  PubMed  Google Scholar 

  3. Elliott RA, Booth JC. Problems with medicine use in older Australians: a review of recent literature. J Pharm Pract Res. 2014;44:258–71.

    Article  Google Scholar 

  4. Landi F, Russo A, Liperoti R, Cesari M, Barillaro C, Pahor M, Bernabei R, Onder G. Anticholinergic drugs and physical function among frail elderly population. Clin Pharmacol Ther. 2007;81:​235–41.

    Article  CAS  PubMed  Google Scholar 

  5. Cao YJ, Mager DE, Simonsick EM, Hilmer SN, Ling SM, Windham BG, Crentsil V, Yasar S, Fried LP, Abernethy DR. Physical and cognitive performance and burden of anticholinergics, sedatives, and ACE inhibitors in older women. Clin Pharmacol Ther. 2008;83:422–9.

    Article  CAS  PubMed  Google Scholar 

  6. Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D, Coulton S, Katona C, Boustani MA, Brayne C. Anticholinergic medication use and cognitive impairment in the older population: the Medical Research Council cognitive function and ageing study. J Am Geriatr Soc. 2011;59:1477–83.

    Article  PubMed  Google Scholar 

  7. Lampela P, Lavikainen P, Garcia-Horsman JA, Bell JS, Huupponen R, Hartikainen S. Anticholinergic drug use, serum anticholinergic activity, and adverse drug events among older people: a population-based study. Drugs Aging. 2013;30:321–30.

    Article  CAS  PubMed  Google Scholar 

  8. Lowry E, Woodman RJ, Soiza RL, Hilmer SN, Mangoni AA. Drug burden index, physical function, and adverse outcomes in older hospitalized patients. J Clin Pharmacol. 2012;52:1584–91.

    Article  PubMed  Google Scholar 

  9. Kersten H, Hvidsten LT, Gløersen G, Wyller TB, Wang-Hansen MS. Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity. Scand J Prim Health Care. 2015;33(4):243–51.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Montero Bancalero FJ. Considerations towards psychoactive drugs in professional and medical students in Spain and medical professionals in Mexico and Colombia. A comparative study (PhD Thesis). Department of Social Clinical Psychology and Experimental. University of Huelva (Spanish) [Internet]. 2014 [Cited 2016 Jan 7]; pp. 1–197. Available from: http://rabida.uhu.es/dspace/bitstream/handle/10272/8855/ Consideraciones_hacia_ los_psicofarmacos.pdf?sequence=2.

  11. Somers M, Rose E, Simmonds D, Whitelaw C, Calver J, Beer C. Quality use of medicines in residential aged care. Aust Fam Physician. 2010;39:413–6.

    PubMed  Google Scholar 

  12. Basger BJ, Chen TF, Moles RJ. Application of a prescribing indicators tool to assist in identifying drug-related problems in a cohort of older Australians. Int J Pharm Pract. 2012;20:172–82.

    Article  PubMed  Google Scholar 

  13. Hollingworth SA, Siskind DJ. Anxiolytic, hypnotic and sedative medication use in Australia. Pharmacoepidemiol Drug Saf. 2010;19:280–8.

    Article  PubMed  Google Scholar 

  14. Hollingworth SA, Siskind DJ, Nissen LM, Robinson M, Hall WD. Patterns of antipsychotic medication use in Australia 2002–2007. Aust NZ J Psychiatry. 2010;44:372–7.

    Article  Google Scholar 

  15. Blogg LC, Suzuki N, Roberts M, Clifford RM. Prescribing benzodiazepines in residential aged-care facilities. J Pharm Pract Res. 2012;42:287–90.

    Article  Google Scholar 

  16. Spina E, Scordo MG. Clinically significant drug interactions with antidepressants in the elderly. Drugs Aging. 2002;19(4):299–320.

    Article  CAS  PubMed  Google Scholar 

  17. Pasina L, Marengoni A, Ghibelli S, Suardi F, Djade CD, Nobili A, Franchi C, Guerrini G. A multicomponent intervention to optimize psychotropic drug prescription in elderly nursing home residents: an Italian multicenter, prospective, Pilot Study. Drugs Aging. 2016;33(2):143–9.

    Article  PubMed  Google Scholar 

  18. Craftman ÅG, Johnell K, Fastbom J, Westerbotn M, von Strauss E. Time trends in 20 years of medication use in older adults: findings from three elderly cohorts in Stockholm, Sweden. Arch Gerontol Geriatr. 2016;63:28–35.

    Article  PubMed  Google Scholar 

  19. Vasudev A, Shariff SZ, Liu K, Burhan AM, Herrmann N, Leonard S, Mamdani M. Trends in psychotropic dispensing among older adults with dementia living in long-term care facilities: 2004–2013. Am J Geriatr Psychiatry. 2015;23(12):1259–69.

    Article  PubMed  Google Scholar 

  20. Etchepare F, Pambrun E, Bégaud B, Verdoux H, Tournier M. Compliance of psychotropic drug prescription with clinical practice guidelines in older inpatients. Fundam Clin Pharmacol. 2016;30(1):82–92.

    Article  CAS  PubMed  Google Scholar 

  21. Administrative Secretariat for Coordination and International Cooperation of the Secretariat of Programming for the Prevention of Drug Abuse and Drug Trafficking. A specific look at the problem of consumption of psychotropic drugs in Argentina 2012 (Spanish). [Internet] 2013. Available from: http://www.observatorio.gob.ar/especificos/ especificos-%20adicionales/Una%20mirada%20especifica%20sobre%20el%20 consumo%20de%20psicofarmacos%20en%20Argentina.2012.pdf.

  22. Leiderman EA, Mugnolo JF, Bruscoli N, Massi J. Psychotropic medication consumption in the Buenos Aires general population 2006 (Spanish). Vertex. [Internet]. 2006 [Cited 2015 Dec 20];17(66):85–91. Available from: http://www.editorialpolemos.com.ar/ docs/vertex/vertex66.pdf.

  23. Schatzberg AF, Cole JO, DeBattista C. Manual of clinical psychopharmacology. Washington, DC: American Psychiatric Pub; 2010. p. 1–720.

    Google Scholar 

  24. Spiegel R. Psychopharmacology: an introduction. Chichester: Wiley; 2003.

    Book  Google Scholar 

  25. National Administration of Drugs, Food and Medical Technology (ANMAT). Definition of psychotropic drugs. Drug regulations (Spanish) [Internet]. 2010 [Cited 2016 Jan 24]. Available from: http://www.anmat.gov.ar/webanmat/Legislacion/Medicamentos/ Disposicion_ANMAT_885- 2010_Definiciones_Psicotropicos.PDF.

  26. Stahl SM. Stahl’s essential psychopharmacology: neuroscientific basis and practical applications. Cambridge: Cambridge University Press; 2008.

    Google Scholar 

  27. Pérez Álvarez M, González PH. The invention of mental disorders: listening to the drug or patient? (Spanish). Madrid: Alianza Editorial; 2007.

    Google Scholar 

  28. Stolerman IP. Encyclopedia of psychopharmacology, vol. 2. Berlin/Heidelberg: Springer; 2010. Available from: https://www.politicalavenue.com/PDF/Encyc​lopedia%20of%20PsychoPharmacology%20(2%20vols)%20-%20I.%20Stolerman%20(Springer,%202010)%20BBS.pdf

  29. De Wet BS. Classification of psycho-active drugs. Paper presented at the 48th South African Medical Congress (MASA); 1971. Available from: http://journals.co.za/docserver/fulltext/m_samj/46/26/31813.pdf?expires=1489265554&id=id&accname=guest&checksum=5EEEF3A67355236C2C7BD11991228E1B

  30. Velasco Martín A, Álvarez González FJ. Compendium of psychoneuropharmacology (Spanish). 1st Ed. Ed. Madrid: Díaz de Santos S.A. Ed.; 1988. p. 55. Available from: http://www.editdiazdesantos.com/libros/velasco-martin-alfonso-compendio-de-psiconeurofarmacologia-C01000860101.html#contenido.

  31. World Health Organization Collaborating Centre for Drug Statistics Methodology. Anatomical Therapeutic Chemical (ATC) index with defined daily doses (DDDs). [Internet]. [Accessed 20 Jan 2016]. Available from: http://www.whocc.no/atc_ddd_index/

  32. Argentine National Observatory on Drugs. Administrative Secretariat for Coordination and International Cooperation of the Secretariat of Programming for the Prevention of Drug Abuse and Drug Trafficking Misuse of psychotropic medications in everyday life. An exploratory study on social representations and usage patterns (Spanish); 2007. Available from: http://www.observatorio.gov.ar/investigaciones/MedicVidaCot.pdf.

  33. Panini A, Garraza M, Teves M, Giraudo E, Calderón C. Chapter 15: Use of psychotropic drugs: between the medicalization and rationality. In: Pascual Ángel G, Humberto Luís Mesones A, editors. Neurosciences and psychiatry update. bridging the divide. Cham: Springer. p. 207–15.

    Google Scholar 

  34. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom. 2015;84:72–81.

    Article  PubMed  Google Scholar 

  35. Offidani E, Guidi J, Tomba E, Fava GA. Efficacy and tolerability of benzodiazepines versus antidepressants in anxiety disorders: a systematic review and meta-analysis. Psychother Psychosom. 2013;82: 355–62.

    Article  PubMed  Google Scholar 

  36. Chouinard G, Chouinard V-A. New classification of selective serotonin reuptake inhibitor withdrawal. Psychother Psychosom. 2015;84:63–71.

    Article  PubMed  Google Scholar 

  37. Starcevic V, Brakoulias V, Viswasam K, Berle D. Inconsistent portrayal of medication dependence, withdrawal and discontinuation symptoms in treatment guidelines for anxiety disorders. Psychother Psychosom. 2015;84:379–80.

    Article  PubMed  Google Scholar 

  38. Fava GA. The hidden costs of financial conflicts of interest in medicine. Psychother Psychosom. 2016;85:65–70.

    Article  PubMed  Google Scholar 

  39. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196–2008.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kinsella K, Phillips DR. Global aging: the challenge of success. Popul Bull. 2005;60:3–42.

    Google Scholar 

  41. Aalami OO, Song HM, Fang TD, Nacamuli RP. Physiological features of aging persons. Arch Surg. 2003;138(10):1068–76.

    Article  PubMed  Google Scholar 

  42. McLean AJ, Le Couteur DG. Aging biology and geriatric clinical pharmacology. Pharmacol Rev. 2004;56(2):163–84.

    Article  CAS  PubMed  Google Scholar 

  43. Nobili A, Garattini S, Mannuccio MP. Review: multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorbidity. 2011;1:28–44.

    Article  Google Scholar 

  44. Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4):430–9.

    Article  PubMed  Google Scholar 

  45. Sousa RM, Cleusa CP, Acosta D, Albanese E, Guerra M, Huang Y, et al. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey. Lancet. 2009;374(9794):1821–30.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Zhang M, Holman CDAJ, Preen DB, Brameld K. Repeat adverse drug reactions causing hospitalization in older Australians: a population-based longitudinal study 1980–2003. Br J Clin Pharmacol. 2007;63:163–70.

    Article  PubMed  Google Scholar 

  47. Pit SW, Byles JE, Cockburn J. Prevalence of self-reported risk factors for medication misadventure among older people in general practice. J Eval Clin Pract. 2008;14:203–8.

    Article  PubMed  Google Scholar 

  48. Miller GC, Britth HC, Valenti L. Adverse drug events in general practice patients in Australia. Med J Aust. 2006;184:321–4.

    PubMed  Google Scholar 

  49. Vuong T, Marriott JL, Kong DCM, Siderov J. Implementation of a community liaison pharmacy service: a randomised controlled trial. Int J Pharm Pract. 2008;16:127–35.

    Article  Google Scholar 

  50. Gnjidic D, Cumming RG, Le Couteur DG, Handelsman DJ, Naganathan V, Abernethy DR, et al. Drug burden index and physical function in older Australian men. Br J Clin Pharmacol. 2009;68:97–105.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Cumming RG, Handelsman DJ, et al. High-risk prescribing and incidence of frailty among older community-dwelling men. Clin Pharmacol Ther. 2012;91:521–8.

    Article  CAS  PubMed  Google Scholar 

  52. Wilson NM, Hilmer SN, March LM, Cameron ID, Lord SR, Seibel MJ, et al. Associations between drug burden index and physical function in older people in residential aged care facilities. Age Ageing. 2010;39:503–7.

    Article  PubMed  Google Scholar 

  53. Wilson NM, Hilmer SN, March LM, Cameron ID, Lord SR, Seibel MJ, et al. Associations between drug burden index and falls in older people in residential aged care. J Am Geriatr Soc. 2011;59:875–80.

    Article  PubMed  Google Scholar 

  54. Best O, Gnjidic D, Hilmer SN, Naganathan V, McLachlan AJ. Investigating polypharmacy and drug burden index in hospitalized older people. Intern Med J. 2013;43:912–8.

    Article  CAS  PubMed  Google Scholar 

  55. Beer C, Hyde Z, Almeida OP, Norman P, Hankey GJ, Yeap BB, et al. Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational. Br J Clin Pharmacol. 2011;71:592–9.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Leach M, Pratt N, Roughead EE. Medicine use among older Australians before and after hip fracture. J Pharm Pract Res. 2013;43:265–8.

    Article  Google Scholar 

  57. Preston JD, O'Neal JH, Talaga MC. Handbook of clinical psychopharmacology for therapists. Oakland: New Harbinger Publications; 2013.

    Google Scholar 

  58. Atypical neuroleptics in elderly patients: acute kidney injury. Prescrire Int. 2015;165:267.

    Google Scholar 

  59. Aizenberg D, Weizman A, Weiss A, Akopian M, Amitai M, Beloosesky Y. The association in elderly hospitalized patients, between psychotropic drugs and hip fractures resulting from falls. Exp Aging Res. 2015;41(5):546–55.

    Article  PubMed  Google Scholar 

  60. Jacquin-Piques A, Sacco G, Tavassoli N, Rouaud O, Bejot Y, Giroud M, Robert P, Vellas B, Bonin-Guillaume S. Psychotropic drug prescription in patients with dementia: nursing home residents versus patients living at home. J Alzheimers Dis. 2015;49(3):671–80.

    Article  Google Scholar 

  61. Jesus C, Jesus I, Agius M. What evidence is there to show which antipsychotics are more diabetogenic than others? Psychiatr Danub. 2015;27(Suppl 1):S423–8.

    PubMed  Google Scholar 

  62. Varma S, Sareen H, Trivedi JK. The geriatric population and psychiatric medication. Mens Sana Monogr. 2010;8(1):30–51.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, Marra CA. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169(21):1952–60.

    Article  PubMed  Google Scholar 

  64. Bloch F, Thibaud M, Dugue B, et al. Psychotropic drugs and falls in the elderly people: updated literature review and meta-analysis. J Aging Health. 2011;23(2):329–46.

    Article  PubMed  Google Scholar 

  65. Hill KD, Wee R. Psychotropic drug-induced falls in older people. A review of interventions aimed at reducing the problem. Drugs Aging. 2012;29:15–30.

    Article  CAS  PubMed  Google Scholar 

  66. Tinetti ME. Preventing falls in elderly persons. N Engl J Med. 2003;341:42–9.

    Article  Google Scholar 

  67. Multiple causes of falls and the role of drugs. Drug therapy information Bulletin of Navarra (Spanish) [Internet]. 2013 [cited 2016 Feb 1];21(2). Available from: http://www.navarra.es/NR/rdonlyres/61C2FB0A-1915-414B-AC23-E60E6A172E87/ 261 957/Bit_v21n3.pdf.

  68. Stephenson CP, Karanges E, McGregor IS. Trends in the utilization of psychotropic medications in Australia from 2000 to 2011. Aust N Z J Psychiatry. 2013;47(1):74–87.

    Article  PubMed  Google Scholar 

  69. Fulton MM, Allen ER. Polypharmacy in elderly: a literature review. J Am Acad Nurse Pract. 2005;17(4):123–32.

    Article  PubMed  Google Scholar 

  70. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5(4):345–51.

    Article  PubMed  Google Scholar 

  71. Veehof LJG, Meyboom-de Jong B, Haaijer-Raskamp FM. Polypharmacy in the elderly – a literature review. Eur J Gen Pract. 2000;6(7):98–106.

    Article  Google Scholar 

  72. Bressler R, Bahal JJ. Principles of drug therapy for elderly patients. Mayo Clin Proc. 2003;78(12):1564–77.

    Article  CAS  PubMed  Google Scholar 

  73. Mangoni AA, Jackson SHD. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Corsonello A, Pedone C, Corica F, Mussi C, Carbonin P, Antonelli Incalzi R, et al. Concealed renal insufficiency and adverse drug reactions in elderly hospitalized patients. Arch Intern Med. 2005;165(7):790–5.

    Article  PubMed  Google Scholar 

  75. Gurwitz JH. Polypharmacy: a new paradigm for quality drug therapy in the elderly? Arch Intern Med. 2004;164(18):1957–9.

    Article  PubMed  Google Scholar 

  76. Steinman MA, Landefeld CS, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516–23.

    Article  PubMed  Google Scholar 

  77. Hilmer SN, Gnjidic D. The effects of polypharmacy in older adults. Clin Pharmacol Ther. 2009;85(1):86–98.

    Article  CAS  PubMed  Google Scholar 

  78. Kuijpers MA, van Marum RJ, Egberts AC, Jansen PA. Relationship between polypharmacy and under-prescribing. Br J Clin Pharmacol. 2008;65(1):130–3.

    Article  PubMed  Google Scholar 

  79. Simonson W, Feinberg JL. Medication-related problems in the elderly. Defining the issues and identifying solutions. Drugs Aging. 2005;22(7):559–69.

    Article  PubMed  Google Scholar 

  80. Linjakumpu T, Hartikainen S, Klaukka T, Veijola J, Kivelä SL, Isoaho R. Use of medications and polypharmacy are increasing among the elderly. J Clin Epidemiol. 2002;55(8):809–17.

    Article  PubMed  Google Scholar 

  81. Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: the prescribing cascade. Br Med J. 1997;315(7115):1096–9.

    Article  CAS  Google Scholar 

  82. Laroche ML, Charmes JP, Nouaille Y, Picard N, Merle L. Is inappropriate medication use a major cause of adverse drug reactions in the elderly? Br J Clin Pharmacol. 2007;63(2):177–86.

    Article  PubMed  Google Scholar 

  83. Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet. 2007;370(9582):173–84.

    Article  PubMed  Google Scholar 

  84. Crentsil V, Ricks MO, Xue QL, Fried LP. A pharmacoepidemiologic study of community-dwelling, disabled older women: factors associated with medication use. Am J Geriatr Pharmacother. 2010;8(3):215–24.

    Article  PubMed  Google Scholar 

  85. Page 2nd RL, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006;4(4):297–305.

    Article  PubMed  Google Scholar 

  86. Hanlon JT, Pieper CF, Hajjar ER, Sloane RJ, Lindblad CI, Ruby CM, et al. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61(5):511–5.

    Article  PubMed  Google Scholar 

  87. Onder G, Pedone C, Landi F, Cesari M, Della Vedova C, Bernabei R, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Soc. 2002;50(12):1962–8.

    Article  PubMed  Google Scholar 

  88. Lai SW, Liao KF, Liao CC, Muo CH, Liu CS, Sung FC, et al. Polypharmacy correlates with increased risk for hip fracture in the elderly: a population-based study. Medicine (Baltimore). 2010;89(5):295–9.

    Article  Google Scholar 

  89. Ziere G, Dieleman JP, Hofman A, Pols HA, van der Cammen TJ, Stricker BH. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol. 2006;61(2):218–23.

    Article  CAS  PubMed  Google Scholar 

  90. Boyle N, Naganathan V, Cumming RG. Medication and falls: risk and optimization. Clin Geriatr Med. 2010;26(4):583–605.

    Article  PubMed  Google Scholar 

  91. Haider SI, Johnell K, Thorslund M, Fastbom J. Trends in polypharmacy and potential drug–drug interactions across educational groups in elderly patients in Sweden for the period 1992-2002. Int J Clin Pharmacol Ther. 2007;45(12):643–53.

    Article  CAS  PubMed  Google Scholar 

  92. Nobili A, Pasina L, Tettamanti M, Lucca U, Riva E, Marzona I, et al. Potentially severe drug interactions in elderly outpatients: results of an observational study of an administrative database. J Clin Pharm Ther. 2009;34(4):337–86.

    Article  Google Scholar 

  93. Koh Y, Kutty FBM, Li SC. Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender. Ther Clin Risk Manag. 2005;1(1):39–48.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Jyrkka J, Enlund H, Korhonen MJ, Sulkava R, Hartikainen S. Polypharmacy status as an indicator of mortality in an elderly population. Drugs Aging. 2009;26(12):1039–48.

    Article  PubMed  Google Scholar 

  95. Sarkar P, Chakraborty K, Misra A, Shukla R, Swain SP. Pattern of psychotropic prescription in a tertiary care center: a critical analysis. Indian J Pharmacol. 2013;45(3):270–3.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Ereshefsky L. Drug–drug interactions with the use of psychotropic medications. Interview by Diane M. Sloan. CNS Spectr. 2009;14:1–8.

    PubMed  Google Scholar 

  97. Johnson JA, Bootman JL. Drug-related morbidity and mortality and the economic impact of pharmaceutical care. Am J Health Syst Pharm. 1997;​54(5):554–8.

    CAS  PubMed  Google Scholar 

  98. Yap KY, Tay WL, Chui WK, Chan A. Clinically relevant drug interactions between anticancer drugs and psychotropic agents. Eur J Cancer Care (Engl). 2011;20:6–32.

    Article  Google Scholar 

  99. Schellander R, Donnerer J. Antidepressants: clinically relevant drug interactions to be considered. Pharmacology. 2010;86:203–15.

    Article  CAS  PubMed  Google Scholar 

  100. Strain JJ, Chiu NM, Sultana K, Karim A, Caliendo G, Mustafa S. Psychotropic drug versus psychotropic drug-update. Gen Hosp Psychiatry. 2004;26:87–105.

    Article  PubMed  Google Scholar 

  101. Baxter K. Stockley’s drug interactions. 9. London: Pharmaceutical Press; 2010.

    Google Scholar 

  102. Zolk O, Fromm MF. Transporter-mediated drug uptake and efflux: important determinants of adverse drug reactions. Clin Pharmacol Ther. 2011;89:798–805.

    Article  CAS  PubMed  Google Scholar 

  103. Muller F, Fromm MF. Transporter-mediated drug-drug interactions. Pharmacogenomics. 2011;12:1017–37.

    Article  PubMed  Google Scholar 

  104. Sansom LN, Evans AM. What is the true clinical significance of plasma protein binding displacement interactions? Drug Saf. 1995;12:227–33.

    Article  CAS  PubMed  Google Scholar 

  105. Chadwick B, Waller DG, Edwards JG. Potentially hazardous drug interactions with psychotropics. Adv Psychiatr Treat [Internet]. 2005 [cited 2016 Jan 16];11(6):440–49. Available from: www.apt.rcpsych.org/content/11/6/440.

  106. Madhusoodanan S, Velama U, Parmar J, Goia D, Brenner R. A current review of cytochrome P45 interactions of psychotropic drugs. Ann Clin Psychiatry. 2014;26(2):120–38.

    PubMed  Google Scholar 

  107. Andrade C. Selective serotonin reuptake inhibitor drug interactions in patients receiving statins. J Clin Psychiatry. 2014;75(2):e95–9.

    Article  CAS  PubMed  Google Scholar 

  108. Drach LM. Psychopharmalogical treatment of delirium in the elderly (German). Med Monatsschr Pharm. 2014;37(4):124–31. quiz 133–124.

    CAS  PubMed  Google Scholar 

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del Carmen Panini, A., Teves, M.R., Giraudo, E., Garraza, M.H., Calderón, C.P. (2017). Psychotropic Medication Use in the Elderly. In: Gargiulo, P., Mesones-Arroyo, H. (eds) Psychiatry and Neuroscience Update - Vol. II. Springer, Cham. https://doi.org/10.1007/978-3-319-53126-7_22

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