Simkó A
Ther Hung. 1989;37(4):187-98.
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.
在老年患者中使用精神药物需要临床医生和全科医生具备专业知识。考虑到老年机体特有的药代动力学和药效学变化,在老年医学中可使用的精神药物种类相对较少。从老年医学角度对药物的动力学和作用机制进行综述后,详细讨论了抗精神病药、抗抑郁药、小剂量镇静剂和催眠药的使用、适应证和禁忌证、不良反应、相互作用风险。总结了老年锂盐治疗的原则,并对所谓的老年病药物(包括所谓的促智药)的临床重要性提出了批评。作者强调心理治疗和社会治疗作为精神药物治疗辅助手段的首要重要性。