Which medication is correctly matched to the condition given of an older adult patient according to current medical knowledge?
a. Methylphenidate (Ritalin) for depression at bedtime
b. Buspirone (BuSpar) for chronic anxiety states
c. Amitriptyline (Elavil) for depression in the morning
d. Haloperidol (Haldol) long-term for psy-chotic behavior
B
Buspirone (BuSpar) is safer for older adults with anxiety than benzodiazepines. Because it can take up to 5 to 7 days for the therapeutic benefit to be realized, it should be used only for chronic anxiety. Stimulants such as methylphenidate (Ritalin) should be administered in low doses in pa-tients with chronic depression. To prevent insomnia, extended-release forms should be adminis-tered early in the morning and short-acting forms at the latest in the early afternoon. Tricyclic antidepressants such as amitriptyline (Elavil) are contraindicated for use with older adults be-cause of the risk for anticholinergic and sedative effects. Tricyclic antidepressants have been re-placed with selective serotonin reuptake inhibitors (SSRIs), which are more effective at lower doses with fewer side effects. Antipsychotic agents such as haloperidol (Haldol) can cause extrapyramidal effects, especially in older adults. For long-term administration, they should be used only after a thorough psychiatric evaluation.
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