Geriatric psychopharmacology: An overview

Introduction The subject of the pharmacological treatment of insomnia is of particular relevance to older adults as the frequency and duration of the pharmacological treatment of insomnia increases with age. This article is intended to provide a general introduction to the process of medical decision-making regarding insomnia medications in older adults. While this process is in principle the same as in younger individuals, it is complicated in the elderly by the potential for more serious consequences of insomnia, the relative absence of available data from placebo-controlled trials upon which to base decisions, and the greater risks of adverse effects. This discussion is meant to serve as a framework for thinking about the pharmacotherapy of insomnia in older adults, which will be discussed in more detail in the subsequent chapters. Treatment decision-making in older adults While chronic insomnia is generally associated with significant morbidity, including sleep disturbance, reduced qualify of life, and reported daytime impairment, it may have particularly serious consequences among older adults. Older adults may be at increased risk for falls/hip fractures, cognitive impairment, nursing home placement, and perhaps even early mortality. These adverse consequences would appear to provide a strong impetus for considering implementing pharmacotherapy for elderly individuals with insomnia in clinical practice.

Duke Scholars

Author Andrew Darrell Krystal Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...