Psych Vivas · Old age psychiatry — psychopharmacology
Prescribing psychotropics in older adults — structured clinical viva
Fellowship viva covering PIM frameworks, start-low-go-slow-but-go, anticholinergic TCA risk, SSRI sodium/QTc/bleeding, antipsychotic caution, and integrated falls/QTc safety.
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Target exams
Interpretation
Reveal interpretation
This is a polypharmacy safety and formulation viva, not a request to rubber-stamp three new CNS drugs. Reconcile indications: temazepam and amitriptyline are high-yield Beers/STOPP problems (falls, anticholinergic load, sedation) in someone with falls and cognitive impairment. "Evening agitation" needs DICE-style assessment (pain, delirium, environment, undertreated depression, benzo effects) before any antipsychotic.[2][8][7]
Do not start quetiapine 50 mg as first response for vague agitation — especially with emerging cognitive impairment and fall risk; if dementia-related severe aggression later needed an antipsychotic, black-box mortality/stroke framing, lowest dose, short course and review date apply.[3] Prefer deprescribing temazepam/TCA pathway with non-drug sleep strategies and pain review.[2]
If syndromal depression is confirmed, choose a safer antidepressant than high-dose citalopram: e.g. sertraline 25 mg orally then 50 mg, with sodium monitoring and bleeding vigilance on anticoagulation; avoid citalopram 40 mg in older adults given QT labelling concerns. ECG and electrolyte awareness for any QT-risk plan.[4][5][6] PK/PD ageing (Mangoni) justifies lower starts and slower titration but not under-treatment of major depression.[1][6]
Key points
[1] [2] [3] [6]References
- [1]Mangoni AA, Jackson SHD Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications Br J Clin Pharmacol, 2004.PMID 14678335
- [2]By the 2023 American Geriatrics Society Beers Criteria Update Expert Panel American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults J Am Geriatr Soc, 2023.PMID 37139824
- [3]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
- [4]Fabian TJ, Amico JA, Kroboth PD, et al. Paroxetine-induced hyponatremia in older adults: a 12-week prospective study Arch Intern Med, 2004.PMID 14769630
- [5]Funk MC, Beach SR, Bostwick JR, et al. QTc Prolongation and Psychotropic Medications Am J Psychiatry, 2020.PMID 32114782
- [6]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391
- [7]Woolcott JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons Arch Intern Med, 2009.PMID 19933955
- [8]O'Mahony D, O'Sullivan D, Byrne S, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2 Age Ageing, 2015.PMID 25324330