Pharmacology of ageing, polypharmacy, deprescribing and non-drug alternatives to psychotropics
Age-related changes in body composition, hepatic and renal clearance and drug sensitivity, prescribing cascades and anticholinergic burden, Beers and STOPP/START, the deprescribing process, and non-drug approaches before psychotropics.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Ageing lowers total body water, raises body fat, reduces liver blood flow and GFR, and makes the brain and circulation more sensitive to drugs.
- Creatinine stays normal while GFR falls, because muscle mass falls too. Calculate a clearance.
- Polypharmacy (5 or more regular medicines) is the strongest predictor of adverse drug events. Prescribing cascades turn side effects into new diagnoses.
Loading the rest of the note…
Finished reading?
Sources
- Australian Medicines Handbook Aged Care CompanionAU/NZAustralian Medicines Handbook Pty Ltd, 2026
- Therapeutic Guidelines: Prescribing in special populations (older people)AU/NZTherapeutic Guidelines Ltd, 2026
- Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care StandardAU/NZAustralian Commission on Safety and Quality in Health Care, 2024
- American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adultsJournal of the American Geriatrics Society 2023;71:2052-81, 2023
- STOPP/START criteria for potentially inappropriate prescribing in older people: version 3European Geriatric Medicine (O'Mahony et al., 2023;14:625-32), 2023
- Reducing inappropriate polypharmacy: the process of deprescribingAU/NZJAMA Internal Medicine (Scott et al., 2015;175:827-34), 2015
- Antipsychotic deprescription for older adults in long-term care: the HALT studyAU/NZJournal of the American Medical Directors Association (Brodaty et al., 2018;19:592-600), 2018
- Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applicationsBritish Journal of Clinical Pharmacology (Mangoni and Jackson, 2004;57:6-14), 2004
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback