• 作者：Naziha Khammassi ; ^{naziha.khammassi@rns.tn} ; Amel Ben Mansour ; Haykel Abdelhedi ; Ouahida Cherif
• 关键词：Effets indé ; sirables ; Iatrogé ; nie ; Psychotropes ; Sujet â ; gé
• 刊名：Annales medico-psychologiques
• 出版年：2012
• 期刊代码：78_00034487
• 类别：psy
• 出版时间：May, 2012
• 卷：170
• 期：4
• 页码：251-255
• 文件大小：204 K

Prerequisites

The iatrogenic effects of psychotropic drugs in the elderly are common, and the reasons are many but in general we can say that the common denominator in this is a metabolic slowdown both in the distribution, metabolism and elimination of drugs.

Purpose

The aim of this study is to clarify the comorbidity associated with this therapy in this slice of age in hospital circle and to indicate the measures of prevention of this iatrogenic.

Methods

Our study is retrospective including 35 old patients (age 鈮?#xA0;65 years), who received a psychotropic treatment in a department of internal medicine.

Results

The sex ratio F/H is 1.2. The average age of patients was 70.26 years 卤 6.81. The main indications for psychotropic drugs are: psychiatric disorders associated with dementia states (13 cases or 37%), psychotic states (12 cases or 34%), mental confusion and anxiodepressive syndromes, respectively in 17%and 20%of cases. Neuroleptic treatment is prescribed in 27 cases (71%), followed by anxiolytics (17 cases; 48%), and antidepressants (nine cases; 25%). Somatic comorbidity is dominated by the vascular affection (51%), metabolic (37%), neurological (37%), hematologic (25%) disease and infection (22%). We noted an important difference with the literature data on the use of atypical antipsychotics (two patients only), and inhibiting the reuptake of serotonin (one patient). Infectious complications especially respiratory and urinary tract are frequent and sometimes dangerous. They occur most often after sedation and prolonged immobilization (five cases). We noted, in this context, two cases of severe dehydration and acute renal failure. Two patients developed delirium under antiparkinsonian. Orthostatic hypotension and fall-related injuries are relatively common (respectively 10 and four cases). Six psychotic patients suffering from tardive dyskinesia. Two patients developed deep vein thrombosis. We found no cases of malignant hyperthermia or sudden death. Outside of psychotropics, antihypertensives, anti-inflammatory and antidiabetics drugs are the major drug classes prescribed in our patients. The potential risks most frequently observed were hypotension, hypoglycemia, and acute renal failure. The respect of counter indication is also a pillar in the management to avoid under and over-dosages sometimes fatal.

Conclusion

The frequency and severity of side effects of psychotropic drugs has increased in the elderly. Some side effects are common to several therapeutic classes; others are specific to certain classes of drugs or certain drugs. A few rules guide the prescription of psychotropic drugs in the elderly.