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Psychopharmacology and Psychiatry Updates

Nov 29, 2018

Here is a summary of this episode:

Geriatric Psychopharmacology

  • Today’s topic is geriatric psychopharmacology.
  • Do one thing at a time. Start low and go slow with medication titration and avoid PRN prescribing. Avoid medications on the Beers list like antihistamines, anticholinergics, and tricyclic antidepressants.
  • In patients with diabetes or those prone to orthostasis, consider ziprasidone or aripiprazole. For glaucoma, consider aripiprazole, risperidone, and quetiapine. For those with Parkinson’s disease, consider low-dose quetiapine or clozapine.
  • The syndrome of inappropriate ADH occurs with SSRI use and is not dose-dependent. Check the serum sodium before the drug is started and at weeks one and two after treatment begins.
  • Lithium is a first line drug for the treatment of acute mania in geriatrics. It is advised to dose it once at night with an immediate acting formulation. Keep serum levels at 0.4 to 0.8 mEq/L.