Managing psychiatric pharmacotherapy in older adults

Explore anxiety disorders in older adults, including generalized anxiety disorder, panic, phobias, OCD, and PTSD, with the Hamilton Anxiety Scale, Beck Anxiety Inventory, and psychotherapy with pharmacotherapy.

Explore benzodiazepines with short to intermediate half-lives and non-benzodiazepines like buspirone for anxiety in older adults, with antidepressants such as fluoxetine or paroxetine as alternatives, plus important safety notes.

Explore sleep physiology and age-related changes, including sleep stages and disorders such as insomnia, sleep apnea, circadian rhythm disorders, and narcolepsy, with sleep diaries guiding diagnosis in older adults.

Treat sleep disorders in older adults with nonpharmacological sleep hygiene, cognitive behavioral therapy, and cautious pharmacotherapy, addressing obstructive sleep apnea and secondary factors while avoiding long-acting benzodiazepines.

Explore pharmacologic management of insomnia in older adults, detailing dosing for benzodiazepines and non-benzodiazepine sedative-hypnotics like zolpidem, zaleplon, eszopiclone, ramelteon, and trazodone.

Examine late-life psychosis, including primary schizophrenia and secondary psychoses tied to Alzheimer’s disease and delirium, and learn signs, symptoms, and diagnostic evaluation.

Assess pharmacologic treatment of psychosis in older adults, comparing conventional and atypical antipsychotics, and outline dosing strategies, adverse effects, and monitoring to prevent tardive dyskinesia and pseudo parkinsonism.

Explore the use of atypical antipsychotics for psychosis in older adults, including risperidone, olanzapine, quetiapine, and clozapine, with dosing, hematologic monitoring, and managing sedation, falls, metabolic risks, and parkinsonian psychosis.

Explore depression in older adults as a treatable, often misdiagnosed condition that can mimic dementia, and learn its assessment, diagnosis, and the role of medical and pharmacological factors.

Explore depression treatment in older adults with psychotherapy and pharmacotherapy, first-line SSRIs, and electroconvulsive therapy for severe cases; plan six months or more of maintenance therapy.

Explore treatment of depression in older adults with antidepressants, including alpha-2 antagonists, serotonin 2 antagonists, and MAO inhibitors, with emphasis on dosing, adverse effects, tapering, and pharmacokinetic interactions.

Examine bipolar disorder in older adults, detailing mania and depression, episode cycles, sleep disturbances, and age-related prevalence, onset patterns, and gender differences in mood symptoms.

Explore pharmacologic and prophylactic management of bipolar disorder in older adults, focusing on mood stabilizers such as lithium, lamotrigine, valproate, and antipsychotics, with cautious antidepressant use.