Monitoring the Mental Health of the Elderly

by | Jan 19, 2015

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It is very common to hear about someone getting on in years and developing dementia or going senile.  Many say the mind is the first thing to go.  It’s long been considered just to be a part of aging.  Though this can be true in some cases, these days there are dozens of conditions in the elderly which aren’t part of the process of the aging body and mind and actually are drug-induced instead. 
Each year 9.6 million adverse drug reactions occur in seniors.  One study in particular found that thirty-seven percent of the reactions were not reported because it was not realized that the drug caused the reaction.  These adverse effects produce behaviors and/or mental health conditions that can be misdiagnosed as a psychiatric disorder, such as depression, or a disease such as Parkinson’s.  Usually, this would mean prescriptions for psychiatric drugs or other drugs to treat the medical condition.  Both are unnecessary since it was another drug that was causing the condition in the first place.  
Without finding the true cause of the condition, the door is open for multiple drug handlings, more disease, more disorders and even death.  We are used to thinking that as a person ages their chances of getting ill are increased, because the body is starting to wear out.  It is common that older folks have many more medications to take regularly, but it is vital that each drug is checked to make sure it is necessary for the well-being of the older person.   Otherwise, the chances of increased medications to handle new ailments leads to increased chances of adverse effects.  This is why monitoring the mental health of the elderly and their overall well-being is essential. 
It is important to know that even commonly used over-the-counter medications can induce psychiatric symptoms such as delirium, mood changes and psychotic symptoms.  Something simple like Advil can cause depression.  Benadryl can cause hallucinations.  Oral and topical decongestants can cause anxiety and nervousness.  Drugs that treat incontinence, diarrhea, allergies and insomnia can also cause forms of psychosis, even at low doses.  If the drug causing the symptoms is isolated and removed, the symptoms disappear.  If one isn’t vigilant about what an elderly person is taking, the door is open for a diagnosis of a psychiatric disorder. 
An important point to keep in mind about psychiatric disorders is that there are no medical tests to diagnose them.  A diagnosis is based solely on someone’s opinions about some symptoms.  The symptoms we are talking about here stem from a drug, but symptoms can also be caused by a physical deficiency or problem.  In essence, a psychiatric disorder diagnosis is just an opportunity to prescribe mind-altering drugs to treat a condition without isolating a cause, coupled with potentially serious adverse side effects. 
It only follows that when a diagnosis of a psychiatric disorder is made, the elderly person’s mental health is going down a dangerous road.  Psychiatric drugs have more dangerous potential side effects, especially in the elderly and some are life-threatening.  On top of this, it isn’t uncommon for psychiatric drugs to be prescribed for a non-psychiatric condition.  
For example, Ambien is a psychiatric drug used to treat insomnia, but it can cause delirium and confusion.  Antipsychotics such as Abilify, Seroquel, Risperdal and Zyprexa are often prescribed to treat behavior associated with dementia.  However, this type of drug can actually worsen dementia and cause anxiety, heart problems, sudden death and irreversible involuntary movements of the body known as Tardive Dyskinesia.  
SSRI antidepressants are often prescribed to the elderly and these drugs may cause suicidal thoughts or homicidal ideation.  Prozac, a well know antidepressant, can even cause symptoms of Parkinson’s.  Benzodiazapines such as Valium and Xanax are prescribed to treat anxiety or insomnia in the elderly, but this type of drug can cause or even worsen dementia and it can also cause suicidal thoughts, seizures, depression and even premature death.  In fact, it has been estimated that more than ten percent of all those that have attended a memory clinic have drug-induced dementia. 
The point is that all these conditions can be prevented if regular routine checks are done regarding the medications a senior is taking.  One can no longer assume that “aging” is the answer for the elderly person’s mental health problems such as dementia, depression, etc. when it actually might be a drug reaction.  Doctors and patients must be cognizant of the fact that any symptom can be worsened by drugs.  Drug reactions cannot be overlooked and must be recognized before the harm has already been done. 
Also keep in mind there could be a trickle down effect.  If a senior takes unnecessary drugs, the resulting delirium or hallucinations could result in a fall and a broken hip for example, or even a car accident.  This obviously leads to other disabilities, increased use of health care services, lack of recovery from the condition a drug was prescribed for in the first place and the list goes on.  All in all, if one is aware that symptoms could be a side effect of a drug, then the disastrous side effects stated above could be prevented. 
Let’s keep a better eye on the elderly and their mental health and well-being.  Everyone will be happier and healthier as a result. 


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