Welcome to the EPA 2022 Interactive Programme 

Abstract Body

According to the data, more than 50% of elderly patients with mental disorders have at least one comorbidity and are treated with multiple medications (e.g. 5 or more medications), which can lead to problems in medication selection and medically unnecessary polypharmacy (i.e., irrational polypharmacy). On the other hand, there are still many untreated patients, which can lead to severe disturbances and an excess death rate. Due to frequent comorbidities and treatments in the elderly, medication-related problems are very frequent. Drug-drug interactions (DDIs) between somatic medications and psychotropics often occur in this population. These patients are also excluded from many clinical trials and consequently, this age group is underrepresented in clinical guidelines, which leads to a lack of evidence-based medicine supported results useful for daily practice. In this context, prudent medication selection is a key step in pharmacotherapy selection. There are some tools available that can help in clinical practice, including different medication lists (e.g., Beers criteria, STOPP/START, and guidelines) and pharmacological recommendations.

The participants will learn about general recommendations on medication selection in this population, focusing on general principles on somatic comorbidities treatment, supported by evidence-based data and real clinical pharmacological tools useful for daily practice.

Abstract Body

The treatment of sleep disorders in older people requires knowledge of the changes in sleep in old age. In the case of multimorbid older people, pharmacological aspects such as interactions must also be taken into account. Sleep in old age is characterised by a lower depth of sleep and more frequent awakenings. The duration of sleep corresponds to that in middle adulthood. In multimorbid older people, sleep is often chronically impaired by pain and/or obstructive breathing disorders. Many medications can have a negative effect on sleep. This applies to cortisone, for example. Antipsychotics can also worsen sleep by worsening nocturnal myoclonia. Ideally, sleep disorders should first be addressed non-pharmacologically. For benzodiazepines, preparations with a short half-life should be chosen. An algorithm is presented.

References:
Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018;18(3):155-165.

Samara MT, Huhn M, Chiocchia V, Schneider-Thoma J, Wiegand M, Salanti G, Leucht S. Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis. ActaPsychiatr Scand. 2020;142(1):6-17.

Abstract Body

This presentation highlights core pharmacological aspects of opioid and non-opioid pain medications in the elderly patient. Specifically, it covers pharmakinetics, pharmacodynamics and drug-drug interactions of select pain medications. The presentation aims to promote safe use of pain medications in the elderly.