Medications prescribed for patients with serious mental illness (SMI) include several categories with safety warnings, which require either special consideration for use or close monitoring. Guidelines exist to assist clinicians to optimize medication selection for older adults, aiding in prevention of common adverse drug events among the elderly. In this activity, you will learn best practices for safety considerations for use of psychotropic medications in older adults. The American Geriatrics Society (AGS) released 2019 updates to the Beers Criteria for Potentially Inappropriate Medication (PIM) use in older adults, and the previous update was released in 2015. The AGS medication recommendations include medications to use with caution, those to examine in relationship to common disease states, as well as medications in comparison for potential medication interactions. These guidelines will be outlined in the context of standard psychiatric practices. Discussion of periodic review of all medications, de-prescribing, and alternatives will also be included.

Learning Objectives

• Identify potentially inappropriate psychotropic medication for use in older adults, allowing for close inspection of benefits and harms among drug categories prescribed for patients with serious mental illness.
• Describe pharmacodynamics and pharmacokinetics warranting special considerations when prescribing psychotropic medications for older adults in order to prevent adverse drug events.
• Examine safety considerations, including patients’ reasonable use of poly-pharmacy, de-prescribing, and use of alternatives for management of psychiatric issues when appropriate.