Medications have become increasingly effective in providing relief from symptoms of mental health disorders. Medications can help the brain recover from mental illnesses by targeting specific neuro-communication pathways and chemical imbalances that disrupt normal brain functioning.
In later life, physical changes occur that impact the human body’s ability to absorb, metabolize and excrete many types of medications. The average number of medications that an older person takes on any given day is seven. Almost half of medications commonly prescribed for older adults have sedating side effects.
The side-effects of one drug can be intensified by the effects of another. This is called “drug-drug interaction”, and older adults must have knowledge of the symptoms and effects of drug interactions. This knowledge comes with clear communication with doctors, pharmacists and other involved health care professionals. For these reasons and more, it is critical that an older adult take medications with regular consultation and oversight of health care professionals.
When talking with a health care professional about potential use of mental health medications, it is important to know the names of all medications taken, the dosage levels and the frequency and times of day that they are taken. It is also very important to include information on any over-the-counter (non-prescription) medications that are taken such as laxatives, aspirin, eye drops, vitamins, herbal remedies, cold medicines, antacids, etc.
Over-the-counter medications are often overlooked though they frequently contribute to negative drug interactions. Some people choose to put all of the medications they take (in the original containers) into a bag to take with them to visit the doctor. This method seems to enhance medication miscommunication.
“Psychotropic medications” are drugs that work to heal illness in the brain. There are many categories of psychotropic medication to address different mental illnesses and symptoms. Because the brain is a delicate, sensitive and vital organ of the body, people must always take psychotropic medications with the consult of a doctor. Psychotropic medications must never be shared. The dosage directions must be carefully followed. People need to know that some medications take several weeks before a beneficial effect is noticed, and they should report any negative side effects to their doctor.
Antidepressant medications are divided into “classes” according to the types of action they take in the brain. Skilled medical professionals select the class of medication to use based on an individual’s symptoms, medical history and other patient information. People should never share medications and they should be patient until the most effective medication is found. Remember, this could take several weeks to determine.
When effective, antidepressant medications will help to restore an individual’s energy level; relieve sleep, appetite and physical problems; improve mood and behavioral symptoms; and generally restore participation in activities and relationships to allow for greater life satisfaction. Studies show, however, that medication is most effective when it is combined with therapy to promote positive coping skills and mental and behavioral changes to move forward in life.
Side-effects of antidepressant medications can be bothersome to some and detrimental or even harmful to others, especially for a person with dementia. Side effects of antidepressants include dry mouth, dizziness, low-blood pressure, confusion and appetite changes. For an older adult, some of these side effects raise the risk of falls and other accidents.
The use of medication for treatment of anxiety disorders is very effective. Anti-anxiety medications are another category of drugs that should be monitored very carefully when used by an older adult. Because these medications can have strong sedating effects that build up quickly in the body of an older person, they are commonly recommended for short-term use. Other effects of anti-anxiety medications include memory problems and risk for dependence.
Doctors should carefully consider a patient’s symptoms, history, other medications and health conditions to choose the safest and most effective medication for anxiety. Sometimes antidepressant medications or blood pressure medications can help with anxiety and agitation.
Sometimes people have hallucinations and delusions (beliefs that do not have root in reality i.e. paranoia) related to mental illness or dementia. Such psychotic symptoms may improve with medications. The side effects of these medications in an older person’s body, however, can be risky and it is essential that people taking antipsychotic medication have frequent monitoring by their doctor. Some of the antipsychotic medications require routine blood tests to monitor the impact of the drug on the body.
Medications may be prescribed to help slow the progression of Alzheimer’s Disease though the efficacy of such medications are controversial. More common are medications to treat the problematic symptoms of dementia such as agitation, depression, anxiety and hostility.
Dietary supplements and herbal remedies are examples of “alternative medications (or therapies)” that are increasingly popular. Such treatments are not considered “drugs” under the FDA (Federal Drug Administration) regulations and thus are not subject to the same criteria for efficacy proof or manufacturing and dosage safety requirements. Nonetheless, these substances can significantly impact body systems and should be considered equally when taken in combination with other medications. Vitamins, minerals and herbal remedies should be considered for their potential interactions and effects. Health care professionals should be told of any alternative medications or therapies being used by an older individual.
Over the Counter Medications
Older adults are the greatest consumers of over-the-counter (OTC) medications which include such things as laxatives, eye drops, cold medicines, antacids, etc. People often mistakenly believe that OTC medications are safe. They usually are, however, they can easily be misused, abused and negatively interact with other medications and therapies. Always report all OTC medication use to your health care provider.
Alcohol is a “depressant” drug that poses a serious risk for over-sedation and negative interference with the healing purpose of a medication. Because alcohol is a commonly used substance and effects the body differently in later life, people should know more about alcohol use and try to avoid it when taking any of the medications described above.