Guidelines for the use of psychopharmaca in geriatric cases

The use of psychotropic drugs in elderly patients requires special knowledge of both clinician and general practitioner. Considering the pharmacokinetic and pharmacodynamic changes characteristic of the senile organism, relatively few of the great variety of psychotropic drugs may be used in geriatrics. After giving a survey of the kinetics and mechanism of action of drugs from geriatric aspects the use, indications and contraindications, unwanted side-effects, the risks of interactions of neuroleptics, antidepressants, minor tranquillizers and hypnotics have been discussed in detail. The principles of gerontological lithium therapy have been summarized and the clinical importance of the so-called geriatrics (including the so-called nootropics) has been subjected to criticism. The author emphasizes the primary importance of psychotherapy and sociotherapy as adjuvants to psychotropic treatment.