McLeod et al identified inappropriate prescription practices for older adults in Canada. Certain prescriptions should be avoided in patients requiring psychotropic drugs. The authors are from McGill University in Montreal.
|
Disorder |
Drug |
Comorbid |
Reason |
|
insomnia |
benzodiazepine, long-acting |
|
falls, confusion, dependence |
|
insomnia |
barbiturate, long-term |
|
falls, confusion, dependence |
|
insomnia |
triazolam |
|
cognitive and behavioral problems |
|
anxiety |
benzodiazepine, long-acting |
|
falls, confusion, dependence |
|
depression |
tricyclic antidepressantt |
glaucoma |
worsen glaucoma |
|
depression |
tricyclic antidepressant |
prostatic hypertrophy |
worsen urinary retention |
|
depression |
tricyclic antidepressant |
heart block |
worsen heart block |
|
depression |
tricyclic antidepressant |
postural hypotension |
falls |
|
depression |
tricyclic antidepressants with active metabolites |
|
anticholinergic side effects |
|
depression |
methylphenidate |
|
agitation, seizures, CNS stimulation |
|
depression |
SSRI |
MAO inhibitor |
adverse side effects |
|
agitation in dementia |
benzodiazepine, long-acting |
|
falls, confusion, dependence |
|
dementia |
nylidrin |
|
ineffective, side effects |
|
dementia |
niacin |
|
ineffective, side effects |
|
dementia |
pentoxifylline |
|
ineffective side effects |
|
psychosis |
chlorpromazine |
postural hypotension |
falls |
where:
• Tricyclic antidepressants with active metabolites include imipramine and amitriptyline.
Specialty: Pharmacology, clinical
