Prescribing psychotropic medication for 85-year-olds is more challenging than in younger adults. Due to age-related changes in hepatic metabolism and renal excretion, older adults may require ½ to 1/3 the dose of medications that younger adults may need to see therapeutic benefits (Desai AK. Clin Geriatr Med 19:697–719, 2003). Older adults are also more likely to be on several prescriptions and over-the-counter medications—hence, the risk of drug-drug interactions is greater (Desai AK, Grossberg GT. Am J Geriatr Psychiatr 11:498–506, 2003). Lastly, older adults are more sensitive to common side effects of medications, even at low doses. The American Society of Consultant Pharmacists has adopted the saying that “any symptom in an elderly patient should be considered a drug side-effect until proven otherwise” (Gurwitz JH, Field TS, Avorn J et al. Am J Med 118:251–258, 2005). They are particularly sensitive to sedating and cognitive-impairing side effects of commonly prescribed agents (Desai AK. Clin Geriatr Med 19:697–719, 2003). It is important for clinicians to be familiar with the Beers Criteria or Beers list of the so-called good drugs and bad drugs in the elderly (Steinman MA, Beizer JL, DeBeau CE et al. J Am Geriatr Soc 63(12):e1–7, 2015).