Steps to prevent or minimize drug-induced cognitive impairment:
(1) Keep the number of drugs given to a patient with risk factors for cognitive impairment to a minimum.
(2) For a given indication use the drug with least risk of cognitive impairment.
(3) Monitor serum drug levels if toxicity is suspected.
(4) Adjust the administered dose for changes in comorbid disease activity.
(5) Adjust the administered dose for additional or removal of other drugs that may cause an interaction.
(6) For a drug that may impact cognition, use the lowest possible effective dose and start therapy gradually if possible.
(7) Try to keep drug levels steady, avoiding swings between maximum and minimum drug levels. This may involve a slow-release preparation or more frequent dosing.
(8) If the patient shows cognitive impairment, review and adjust the dosage of any medications being taken.
