Pharmacotherapy: Safe Prescribing and Adverse Drug Events

Geriatric patients are likely to be treated with multiple medications for illnesses affecting many organ systems. The addition of psychotropic medication(s) to the regimens of patients already receiving many other medications must therefore be done only after consideration of the many factors that may affect safety and side effects. These factors include side effects attributable to psychotropic medications themselves, drug-drug interactions, and considerations of age-related changes in drug absorption, pharmacokinetics, and pharmacodynamics. This chapter addresses the issues of polypharmacy in geriatric patients and the specific central nervous system and systemic side effects that need to be actively considered when prescribing psychotropic medications to treat various psychiatric illnesses. Because geriatric patients often have multiple clinicians prescribing medications for multiple illnesses, communication among clinicians and active use of pharmacy profiling are recommended to facilitate safe medication prescribing and monitoring.