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Once the patient responds, the dose should be titrated down, if possible, to the lowest effective dose. Clinical trial data relating to dosing, efficacy, and safety of these drugs in the elderly are limited.Antipsychotics can reduce paranoia but may worsen confusion (see also Schizophrenia : Conventional antipsychotics).Risk of lactic acidosis, a rare but serious complication, increases with degree of renal impairment and with patient age. In many elderly patients, lower starting doses of antihypertensives may be necessary to reduce risk of adverse effects; however, for most elderly patients with hypertension, achieving BP goals requires standard doses and multidrug therapy.Initial treatment of hypertension in the elderly typically involves a thiazide-type diuretic, ACE inhibitor, angiotensin II receptor blocker, or dihydropyridine Ca channel blocker, depending on comorbidities.Nonpharmacologic measures, such as cognitive-behavioral therapy, and sleep hygiene (eg, avoiding caffeinated beverages, limiting daytime napping, modifying bedtime) should be tried first.If they are ineffective, nonbenzodiazepine hypnotics (eg, ) are options for short-term use.

Although antidepressants may not cure depression, they can reduce symptoms. But if it doesn't relieve your symptoms or it causes side effects that bother you, you may need to try another.

Mark Ruscin, Pharm D, FCCP, BCPS, Professor and Chair, Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy ; Sunny A.

Linnebur, Pharm D, BCPS, BCGP, Professor of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences In patients with heart failure, risk of hyperkalemia especially if also taking an NSAID, ACE inhibitor, angiotensin receptor blocker, or K supplement; avoid in heart failure or if creatinine clearance May be appropriate for seizure disorders, rapid eye movement sleep disorders, benzodiazepine withdrawal, ethanol withdrawal, severe generalized anxiety disorder, periprocedural anesthesia, end-of-life care Serious adverse effects include peptic ulceration and upper GI bleeding; risk is increased when an NSAID is begun and when dose is increased.

β-blockers should be reserved for 2nd-line therapy.

Short-acting dihydropyridines (eg, ) may increase mortality risk and should not be used.

Although antidepressants may not cure depression, they can reduce symptoms. But if it doesn't relieve your symptoms or it causes side effects that bother you, you may need to try another. Mark Ruscin, Pharm D, FCCP, BCPS, Professor and Chair, Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy ; Sunny A.Linnebur, Pharm D, BCPS, BCGP, Professor of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences In patients with heart failure, risk of hyperkalemia especially if also taking an NSAID, ACE inhibitor, angiotensin receptor blocker, or K supplement; avoid in heart failure or if creatinine clearance May be appropriate for seizure disorders, rapid eye movement sleep disorders, benzodiazepine withdrawal, ethanol withdrawal, severe generalized anxiety disorder, periprocedural anesthesia, end-of-life care Serious adverse effects include peptic ulceration and upper GI bleeding; risk is increased when an NSAID is begun and when dose is increased.β-blockers should be reserved for 2nd-line therapy.Short-acting dihydropyridines (eg, ) may increase mortality risk and should not be used.In nonpsychotic, agitated patients, antipsychotics control symptoms only marginally better than placebo and can have severe adverse effects.