Journal of Geriatric Psychiatry and Neurology

 

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Journal of Geriatric Psychiatry and Neurology, Vol. 20, No. 4, 199-214 (2007)
DOI: 10.1177/0891988707308803

Neurocognitive Costs and Benefits of Psychotropic Medications in Older Adults

John O. Brooks, PhD, MD

Palo Alto Veterans Affairs Health Care System and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, johnbrooks{at}stanford.edu

Jennifer C. Hoblyn, MD, MPH

Palo Alto Veterans Affairs Health Care System and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

Psychotropic medications are widely used in older adults and may cause neurocognitive deficits. Older adults are at increased risk of developing adverse effects because of age-related pharmacodynamic and pharmacokinetic changes. This article provides a comprehensive review of the undesirable, and at times beneficial, effects of psychotropic medications. The review covers a wide range of medications that impair executive function, memory, and attention, as well as a much smaller group of medications that lead to improved neurocognitive function. Some of the most commonly used psychotropic medications in older adults, namely, antidepressants, sedatives, and hypnotics, are among the drugs that most consistently lead to cognitive impairments. Medications with anticholinergic properties almost invariably lead to neurocognitive dysfunction, despite symptom improvement. The neurocognitive costs and benefits of psychiatric medications should be considered in the context of disease treatment in older adults. (J Geriatr Psychiatry Neurol 2007;20:199—214)

Key Words: elderly • cognition disorders • psychopharmacology • adverse effects • memory • attention


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