The Challenges of ‘Father Time’

Both medical and non medical clinicians will likely be seeing more elderly patients as the oldest of the “baby boomers” are on the cusp of retirement. In the United States, people aged 65 and over make up just 13 percent of the total population, but account for 30 percent of all prescriptions written.

Changes in mental status can be drug related. For example, benzodiazepines (Valium, Xanax, Ativan), can cause drowsiness, confusion, prolonged sedation and memory loss.

Watch for signs of noncompliance. It sometimes takes longer to see a therapeutic effect with psychotropic medications used in seniors, placing them at risk for abruptly discontinuing their medications due to slowed response rates. Advancing age is often accompanied by less patience. Older adults should be encouraged to continue to take their medications unless otherwise instructed by their physician or other prescriber to discontinue.

Memory tends to decline with age also. Encourage aging patients to enlist the aid of a family member to help them keep an updated list of medications with them at all times. Other family members should have this list also.

Elderly patients may be obtaining their prescriptions from more than one pharmacy. Encourage them to use only one source for the purchase of all medications – prescription and over-the-counter. All major pharmacies have computer software than can scan for potentially problematic drug interactions.

Finally, watch for additional medications prescribed to ameliorate the side effects of an already prescribed drug. For example, a sleep aid may be prescribed to offset the side effect of insomnia from an antidepressant. This can set up a potentially dangerous and vicious cycle of polypharmacy, and should be brought to the attention of the patient’s prescriber immediately.

Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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