Practical issues in geriatric psychopharmacology.

In summary, clinicians must consider multiple changes in the absorption, distribution, metabolism, and elimination of psychotropic drugs among older patients. Lower starting doses (often one-quarter to one-half the usual adult dose) is advisable, with slow dosing adjustments (no sooner than every 5 to 7 days) as needed. The time required to see steady-state therapeutic levels, or for elimination of most medications, are substantially longer in the elderly. One must consider the potential for drug-drug interactions, as well as anti-cholinergic or other side-effects, when prescribing a regimen. Changes should be made slowly, changing only one variable at a time, in order to achieve best results.