Psychotropic drugs in the aged

Plasma levels and effects of nortriptyline in geriatric depressed patients

Pharmacokinetic, therapeutic effects, and side effects of nortriptyline were studied in geriatric depressed patients treated with a standard dose of 150 mg/day. Plasma levels and elimination half-life of nortriptyline were no different in geriatric patients than younger patients. The antidepressant therapeutic effects of nortriptyline appeared to be similar in geriatric patients as in younger depressed patients. Geriatric patients experienced few subjective side effects of nortriptyline. Overall, the drug produced no clinically significant changes in several parameters of the EKG, and no geriatric patient experienced tachycardia on nortriptyline. Nortriptyline did induce significant orthostatic hypotension in the systolic component, but not in the diastolic component. However, the orthostatic hypotension produced by nortriptyline was not greater in geriatric patients than in younger patients treated with the same dose.

Age-associated changes of responses to acetylsalicylic acid

Aspirin can be an effective antipyretic, analgesic and anti-inflammatory agent, but unfortunately, its use in the elderly is often excessive [43]. In a survey by Gillies and Skyring, the overall prevalence of daily aspirin intake was greater in middle-age and older-age groups than for those of less than 40 years of age [16]. The elderly are susceptible to the advertising of non-prescription drugs and aspirin is frequently self-prescribed [8,31]. Age-related physiological changes modify the response to aspirin in the elderly. A higher incidence of drug reactions and interactions has been evidenced in this age group. The cases cited throughout this report substantiate the need for caution on the part of the geriatric patient and the physician in regard to aspirin therapy for the elderly.