Answer to Question 1
Drug treatment is complicated by difficulty in diagnosing the source of the problems, e.g., the symptoms of depression may be confused with those of dementia (or vice versa), or may be the result of other medications taken for other health problems. Because of multiple health problems that require different medications, the elderly may be at risk for exhibiting complex and harmful drug interactions. Due to changes in pharmacokinetics as a result of aging, e.g., decreased rate of drug metabolism and excretion, decreased drug binding to plasma proteins, the elderly are more susceptible to drug toxicity. This requires that dosages of psychotropic drugs in the elderly be reduced to one-third to one-half of dosages appropriate for young adults and requires dosages to be increased only very gradually.
Answer to Question 2
The major side effects include parasympathetic effects, but also CNS effects including the induction of parkinsonian motor symptoms such as slowness of movement and tremor.
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