Vernay D, Dordain G
Service de neurologie, hôpital Nord, Clermont-Ferrand.
Rev Prat. 1990 May 21;40(15):1385-9.
The incidence of adverse reactions to drugs is two or three times greater in elderly people than in adults. Elderly people are great consumers of psychotropic drugs which are most often responsible for these reactions, the chief culprits being anticholinergics and neuroleptics. These drugs must be avoided at that age, but neuroleptics may be justified in some circumstances, such as uncontrollable excitement or delusions. The dysautonomia associated with ageing induces functional disorders that are similar to those induced by psychotropic drugs, so that the responsibility of these drugs is frequently under-evaluated. In those rare cases where psychotropic agents are mandatory, only one of them must be prescribed in low doses and, whenever possible, for a limited period.
老年人药物不良反应的发生率比成年人高两到三倍。老年人是精神药物的大量使用者,而这些药物往往是这些反应的主要原因,主要罪魁祸首是抗胆碱能药物和抗精神病药物。在那个年龄段必须避免使用这些药物,但在某些情况下,如无法控制的兴奋或妄想,抗精神病药物可能是合理的。与衰老相关的自主神经功能障碍会引发与精神药物诱发的功能障碍相似的症状,因此这些药物的责任常常被低估。在那些极少数必须使用精神药物的情况下,只能低剂量开一种药,并且只要有可能,用药时间应有限。