Considerations in the use of psychotropic drugs in elderly mentally retarded persons

Abstract

ABSTRACT. Elderly people tend to be large consumers of medication in general and psychotropic drugs in particular. Sedative/hypnotics, anxiolytics, antidepressants, and neuroleptic drugs tend to be the most commonly used psychotropic medications among elderly people who are not developmentally disabled. These drugs are probably commonly employed among elderly mentally retarded people as well; although the rank order of use probably differs. A number of physiological changes which accompany greater age are described and the impact on pharmacokinetic variables outlined. Other factors associated with aging, which influence drug actions, are also outlined. The net effect appears to be that most drugs are more potent, more toxic, or longer lasting among the elderly. Data are also presented on tardive dyskinesia insofar as aging is concerned. This is followed by overall conclusions and some suggested guidelines for the use of these drugs in older mentally retarded persons.

Prevalence and Associated Risk Factors of Oral Mucosal Lesions and Orofacial Dyskinesia in Patients with Psychotic Disorders

“…This is consistent with findings in other studies wherein ageing was observed as a critical factor in developing dyskinesia [44]. The explanations that have been suggested that associate age with dyskinesia are increased incidence of medical illness with advancing age and neurochemical changes [45].Matson and colleagues suggested decrease in drug metabolism capacity with advancing age as a risk factor for dyskinesia [44]. Other reported non-modifiable risk factors not observed in this study are female sex, race and duration of mental disorder [46].…”

Intelligenzminderung

“…Beipsychischen Störungenund Ve rhaltensstörungen im Rahmen einer geistigen Behinderung ist meist eines yndromorientierte, differenzierte undindividuelle Psychopharmakotherapiee rforderlich, insbesondere wenn dieIntegrationund Rehabilitationgefährdet ist undm it psychotherapeutischen, soziotherapeutischen oder heilpädagogischen Maßnahmen keineT herapieerfolge erzielbar sind (18,25,40,45,72).Die Psychopharmakotherapie unterscheidet sich in ihren Grundsätzen kaum vond er bei Normalintelligenten,w obei diee rhöhteE mpfindlichkeit vonM enschen mit hirnorganischen Störungeng egenüber Nebenwirkungen zu beachten ist (17,19,52),insbesondere bei älteren geistig Behinderten (2).…”

Mental and physical health and ageing in mental handicap: a review

“…The link between mental health and frequency of social interaction in care facilities emphasizes the need to pay as much attention to emotional and psychological needs as physical care needs. The high use of psychoactive drugs, in the absence of a clear psychiatric diagnosis in the elderly mentally handicapped, revealed in many studies, and the possible deleterious effects on mental and physical health indicate a need for more careful drug prescribing and regular monitoring (Aman 1990). More sensitive preparation for residential care when ageing parents can no longer cope (Carter 1984;Seltzer & Seltzer 1985), greater awareness of bereavement reactions (McLoughlin 1988) and the early provision of bereavement counselling (Hollins & Sireling 1991) could substantially reduce the morbidity from depression which so frequently follows the illness or death of a last caring relative.…”