Anxiety and insomnia are common problems in the institutionalized elderly. If behavioral measures are not successful, antidepressant medications with shorter half-lives may avoid drug accumulation, which can lead to excessive sedation, cognitive impairment and an increased risk for falls.
Side effects of particular concern in the elderly include anticholinergic reactions, parkinsonian events, tardive dyskinesia, orthostatic hypotension, cardiac conduction disturbances, reduced bone mineral density, sedation, and cognitive slowing.
Drug-related problems are common in older adults and include drug ineffectiveness, adverse drug effects, overdosage, underdosage, inappropriate treatment, inadequate monitoring, nonadherence, and drug interactions. (See also Overview of Drug Therapy in Older Adults.
Physical effects include appetite changes, impaired body movement, and fatigue. Long-term, damage can occur to the gastrointestinal system if the drug is eaten or to the lungs if the drug is smoked. Most harm comes from damage to the brain, including to cognition and memory.
Psychotropic drugs are prescribed to treat a variety of mental health issues when those issues cause significant impairment to healthy functioning. Psychotropic drugs typically work by changing or balancing the amount of important chemicals in the brain called neurotransmitters.
Psychotropic medication is a broad term referring to medications that affect mental function, behavior, and experience (NSW Department of Health, 1997). Psychotropic medications are typically administered to older adults to manage symptoms of anxiety, depression, psychological distress, and/or insomnia.
Anticholinergic: Anticholinergic effects such as constipation, dry mouth, blurred vision, and urinary retention are particularly problematic in the elderly and may contribute to delirium. They are most common with low-potency traditional antipsychotic agents (e.g., chlorpromazine) and clozapine.
Tardive syndromes Tardive dyskinesia is one of the most dreaded complications of antipsychotic treatment, though it may also occur with other medication classes72.
First-generation antipsychotics have a high rate of extrapyramidal side effects, including rigidity, bradykinesia, dystonias, tremor, and akathisia. Tardive dyskinesia (TD)—that is, involuntary movements in the face and extremities—is another adverse effect that can occur with first-generation antipsychotics.
More Diseases That Affect the Response to Drugs: Older adults are much more likely than younger adults to have at least one disease — such as liver or kidney damage (not just the decreased function of older age), poor circulation, and other chronic conditions that alter their response to drugs.
Inappropriate drug selection
Some types of medication-related problems include:
And long-term use has been proven to create a lifetime of physical and mental damage, a fact ignored by psychiatrists. Common and well-documented side effects of psychiatric drugs include mania, psychosis, hallucinations, depersonalization, suicidal ideation, heart attack, stroke and sudden death.
Examples of psychotropic substances include alcohol, caffeine, nicotine, marijuana, and certain pain medicines. Many illegal drugs, such as heroin, LSD, cocaine, and amphetamines are also psychotropic substances. Also called psychoactive substance.
Research on other kinds of structural brain changes caused by antipsychotic drugs has been negative to date. There is no evidence, for example, that antipsychotic drugs cause any loss of neurons or neurofibrillary tangles such as are found in Alzheimer’s disease.