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Clinical pharmacological management of polypharmacy in old age depression

Published online by Cambridge University Press:  23 March 2020

P. Baumann  and
W. Greil
P. Baumann*
Affiliation:
University Department of Psychiatry (DP-CHUV), Prilly-Lausanne, Switzerland
W. Greil
Affiliation:
Psychiatric Department, Universität München, München, Germany Psychiatric Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
*
* Corresponding author.

Abstract

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Polypharmacy is the rule in psychogeriatric patients, as they present frequently comorbidities such as depression, dementia [often including Behavioral and Psychological Symptoms of Dementia (BPSD)] and somatic diseases. Recommended treatments for geriatric depression are antidepressant medications, psychotherapy and psychosocial interventions [1]. Besides antidepressants, other psychotropic drugs are often co-prescribed, but somatic drugs are also needed for the treatment of other concomitant diseases. This situation increases the risk for adverse effects due to pharmacokinetic and pharmacodynamic interactions, especially since the organism of elderly patients displays a lowered homeostatic reserve and a decrease of functions, which allows resisting to xenobiotic influences.

On the other hand, there are also studies which suggest that in hospitalized psychogeriatric patients, the incidence of severe adverse reactions is lower in patients > 60 y than in those < 60 y [2]. This is one of the results of the AMSP-study group, which in German speaking countries has developed a pharmacovigilance program in psychiatric hospitals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
S65
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S39
Copyright
Copyright © European Psychiatric Association 2016

References

Dines, P. Hu, W. Sajatovic, M. Depression in later-life: an overview of assessment and management. Psychiatr Danub 2014; 26Suppl. 178–84Google ScholarPubMed
Greil, W. Haberle, A. Schuhmann, T. Grohmann, R. Baumann, P. Age and adverse drug reactions from psychopharmacological treatment: data from the AMSP drug surveillance programme in Switzerland. Swiss Med Wkly 2013; 143 w13772Google ScholarPubMed
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