Geriatric psychopharmacology
DOI:
https://doi.org/10.25118/2763-9037.2011.v1.857Keywords:
elderly, psychopharmacology, geriatricsAbstract
The development of geriatric psychopharmacology occurred in the last 30 years after the major changes that occurred in psychiatry and the accelerated aging of the population. This study aims to present a historical overview of the development of geriatric psychopharmacology with a description of the advances in the three main classes of psychiatric medications used by the elderly: antidepressants, antipsychotics and medications for the treatment of Alzheimer's disease. Nortriptyline was the first option for the treatment of depression in geriatrics for many years. However, after the emergence of selective serotonin reuptake inhibitors, a reduction in its use was observed. The same occurred with conventional antipsychotics, which were gradually replaced by the use of atypical antipsychotics. However, atypical antipsychotics should be used with great caution in the elderly due to the increased risk of obesity, diabetes, glucose intolerance and hypercholesterolemia in this population. The increased risk of mortality observed with the use of atypical antipsychotics in the treatment of behavioral disorders must also be taken into account. Regarding acetylcholinesterase inhibitors, there are no major differences in efficacy and tolerability, however, there are no direct comparisons between these substances. Finally, geriatric psychopharmacology allows us to clarify more precisely how specific clinical or neurological lesions can contribute to psychiatric symptoms in the elderly. In addition, it contributes to a better understanding of the boundaries between brain structures and functions with the development of pathological processes and their psychiatric treatments.
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