American Journal Geriatric Pharmacotherapy最新文献

{"title":"Cholinesterase Inhibitors: Applying Pharmacokinetics to Clinical Decision Making","authors":"Irving H. Gomolin MDCM ,&nbsp;Candace Smith PharmD ,&nbsp;Thomas M. Jeitner PhD","doi":"10.1016/j.amjopharm.2011.06.001","DOIUrl":"10.1016/j.amjopharm.2011.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Cholinesterase inhibitors<span> are indicated for the treatment of Alzheimer-type dementia. There are few direct comparative studies of adverse effects or studies to suggest clinical superiority of one inhibitor over the others.</span></p></div><div><h3>Objective</h3><p>The objective of this study was to relate pharmacokinetic differences among the agents to potential clinical considerations.</p></div><div><h3>Methods</h3><p>Population pharmacokinetics were obtained from US Food and Drug Administration–approved label information and published literature. Plasma concentration–time profiles were derived from these parameters using noncompartmental pharmacokinetic modeling.</p></div><div><h3>Results</h3><p>Plasma concentration profiles differed significantly among different agents and between different formulations of the same agent.</p></div><div><h3>Conclusions</h3><p><span>The initial choice among the various cholinesterase inhibitors requires consideration to adherence and cost. Consideration to differences in pharmacokinetics among these drugs provides a better understanding for the clinical practice of </span>dose titration, identification and management of drug-related side effects, and lapses in therapy. Pharmacokinetic considerations among the various agents and formulations provide the clinician with options to enhance therapy when these agents are chosen for treatment of patients with Alzheimer-type dementia.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 4","pages":"Pages 259-263"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29866483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Discrepancies Identified at Time of Hospital Discharge in a Geriatric Population","authors":"Danielle M. Stitt PharmD ,&nbsp;David P. Elliott PharmD ,&nbsp;Stephanie N. Thompson PhD","doi":"10.1016/j.amjopharm.2011.06.002","DOIUrl":"10.1016/j.amjopharm.2011.06.002","url":null,"abstract":"<div><h3>Background</h3><p>It has been reported that 14.1% of geriatric patients experience ≥1 medication discrepancies after hospitalization.</p></div><div><h3>Objective</h3><p>The goal of this study was to identify and characterize discharge medication list discrepancies among geriatric patients and to describe characteristics associated with discrepancies.</p></div><div><h3>Methods</h3><p><span>An institutional review board–approved retrospective review was conducted of patients aged ≥65 years discharged from hospitalist and </span>internal medicine services at a large tertiary care hospital from August 2008 to December 2009. A random cohort of 200 patients was selected and categorized by age, gender, attending medical service, and the absence or presence of a pharmacist on the service. Medication lists were obtained from physician discharge summaries, discharge orders, and nursing discharge lists.</p></div><div><h3>Results</h3><p><span>A total of 1923 medication discrepancies were identified, consisting of 402 related to the absence or presence of a medication, 298 related to the dosage administered at one time, 223 related to the number of daily doses, and 1000 related to the route of administration. Physician discharge summaries contained the most medication discrepancies. There was no relationship between patient age and the number of medication discrepancies (</span><em>r</em>² = 0.006; <em>P</em> = 0.279), whereas there was a linear relationship between the number of medications and the number of discrepancies (<em>r</em>² = 0.249; <em>P</em> &lt; 0.001). The internal medicine team with a pharmacist had a lower average number of discrepancies per patient compared with other medicine services that did not have a pharmacist present.</p></div><div><h3>Conclusions</h3><p>Medication discrepancies at the time of hospital discharge are a common occurrence for geriatric patients. Physician summaries might be the least reliable source of discharge medication lists. The number of discrepancies appears to not be associated with patient age, but rather with the number of medications at discharge. Discrepancies among medication lists are common, and the presence of a pharmacist may reduce the number that occur.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 4","pages":"Pages 234-240"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29866484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Diabetes and the Burden of Comorbid Conditions Among Elderly Nursing Home Residents","authors":"Sharon B. Dybicz PharmD ,&nbsp;Stephen Thompson MS ,&nbsp;Sandra Molotsky BSN ,&nbsp;Bruce Stuart PhD","doi":"10.1016/j.amjopharm.2011.05.001","DOIUrl":"10.1016/j.amjopharm.2011.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Although the reported prevalence of diabetes in nursing home residents varies greatly among studies, there remains a common trend: increasing prevalence. Diabetes in the elderly is often associated with the presence of multiple comorbid conditions. However, limited data exist regarding the characteristics, symptom severity, disease management, and outcomes of care for residents of nursing homes with diabetes.</p></div><div><h3>Objective</h3><p>Our aim was to estimate the prevalence of diabetes in a national sample of skilled nursing facility (SNF) residents over a 12-month period and to examine differences in the burden of comorbidities between elderly residents with and without diabetes, including prevalence and severity of comorbidities, pharmacotherapy associated with these conditions, and cost.</p></div><div><h3>Methods</h3><p>This was a multicenter, observational, medical utilization evaluation study in 23 geographically representative SNFs in the United States. Comorbidities, cognition, physical activity, utilization of health services, and medications were obtained from medical chart audits, minimum data set records, and prescription claims files. Chart abstraction was performed between June 2006 and March 2007. Residents eligible for inclusion in the prevalence analysis were aged ≥65 years, did not receive hospice care, and were not in a persistent vegetative condition.</p></div><div><h3>Results</h3><p>A total of 2317 residents met the inclusion criteria and were included in the prevalence analysis; 761 (32.8%) had diabetes. Residents with a full minimum data set assessment within 12 months before chart abstraction (n = 2095) were included in the comorbid burden analysis. Compared with those without diabetes, a greater proportion of residents with diabetes were younger, male, Hispanic or African American, and were overweight or obese. Residents with diabetes had a greater comorbidity burden (Hierarchical Condition Category, 1.90 vs 1.58), including more prescribed medications for certain common comorbid conditions (including angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers [46% vs 24%], diuretics<span> [44% vs 34%], statins [40% vs 18%], or antiplatelets/antithrombotics [43% vs 37%]), and experienced more hospitalizations (37% vs 18% at 6 months) than residents without diabetes.</span></p></div><div><h3>Conclusion</h3><p>Nearly one third of elderly SNF residents had diabetes. These patients, compared with SNF residents without diabetes, had a greater comorbid burden, were prescribed more medications to treat these conditions, and had more hospitalizations.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 4","pages":"Pages 212-223"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29924632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric Pharmacotherapy Updates","authors":"David R.P. Guay PharmD","doi":"10.1016/j.amjopharm.2011.06.003","DOIUrl":"https://doi.org/10.1016/j.amjopharm.2011.06.003","url":null,"abstract":"","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 4","pages":"Pages 264-269"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137394279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic Use and the Risk of Diabetes in Nursing Home Residents with Dementia","authors":"Jessica J. Jalbert PhD ,&nbsp;Lori A. Daiello PharmD ,&nbsp;Charles B. Eaton MSc, MD ,&nbsp;Susan C. Miller MBA, PhD ,&nbsp;Kate L. Lapane PhD","doi":"10.1016/j.amjopharm.2011.04.006","DOIUrl":"10.1016/j.amjopharm.2011.04.006","url":null,"abstract":"<div><h3>Background</h3><p>Growing evidence suggests an association between antipsychotic use and diabetes onset in schizophrenia, but little is known about this association among patients with dementia.</p></div><div><h3>Objective</h3><p>The aim of this study was to quantify the association between antipsychotic use and the risk of diabetes onset among nursing home residents with dementia.</p></div><div><h3>Methods</h3><p>We conducted a nested case-control study in 29,203 long-stay Medicaid-eligible residents living in nursing homes in California, Florida, Illinois, New York, and Ohio between January 2001 and December 2002 who were at least 65 years old with a dementia diagnosis and no record of diabetes within 90 days of nursing home admission. We identified 762 incident cases of diabetes and randomly selected up to 5 controls, matched on nursing home and quarter of minimum data set (MDS) assessment (N = 2646). Cases of incident diabetes were identified from MDS assessments and Medicaid claims, medication use was ascertained from Medicaid pharmacy files, and resident characteristics were obtained from MDS assessments.</p></div><div><h3>Results</h3><p>Relative to non-users of antipsychotics, use of atypical antipsychotics<span> was not associated with diabetes onset (adjusted odds ratio [AOR] = 1.03; 95% CI, 0.84–1.27) and risk of diabetes did not increase with length of time on treatment. Conventional antipsychotic treatment was associated with diabetes onset, particularly when treatment duration was &lt;30 days (AOR = 2.70; 95% CI, 1.57–4.65).</span></p></div><div><h3>Conclusions</h3><p>Among nursing home residents with dementia, conventional antipsychotic therapy, particularly short-term therapy, increased their risk of developing diabetes. Atypical antipsychotic use was not associated with an increased risk of diabetes onset.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 153-163"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.04.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40096142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Prevention of Stroke in the Elderly: A Review of the Evidence","authors":"Ahmed Alhusban PharmD ,&nbsp;Susan C. Fagan PharmD","doi":"10.1016/j.amjopharm.2011.04.002","DOIUrl":"10.1016/j.amjopharm.2011.04.002","url":null,"abstract":"<div><h3>Background</h3><p><span>Stroke is a major health problem with significant impact on the affected individuals and the whole community. In light of stroke being the leading cause of disability, the ageing of the population and the high incidence of stroke among the elderly, highlight the importance of primary and secondary prevention interventions among this group. The elderly generally have been underrepresented in </span>clinical trials, creating many uncertainties and less optimal medical care for this group of patients.</p></div><div><h3>Objective</h3><p>This review aims to make evidence-based management recommendations for secondary stroke prevention in the elderly.</p></div><div><h3>Methods</h3><p>Secondary prevention–related primary literature was identified using MEDLINE and PubMed (1982 to present) with combinations of the following search terms being employed: <span><span><em>antiplatelets</em><em>, </em></span><em>aspirin</em><span><em>, </em><em>atrial fibrillation</em><span><em>, elderly, </em><em>geriatrics</em><span><em>, hypertension, lipids, secondary prevention, </em><em>statins</em><em>, stroke,</em></span></span></span></span> and <em>warfarin</em>. In addition, the references of these articles were also reviewed.</p></div><div><h3>Results</h3><p><span><span><span>Twenty-three clinical trials were included in this review, covering different aspects of secondary stroke prevention. Many of these trials were not specifically limited to the elderly, but conclusions related to their care can be derived from them. Although the American Heart Association/American Stroke Association guidelines suggest an equal benefit of aspirin, aspirin/dipyridamole, and clopidogrel in secondary prevention, the use of aspirin in the elderly may be preferred for reasons related to compliance and experience. Warfarin was largely avoided in the management of elderly stroke patients in the past, although available evidence demonstrates its efficacy and safety as a first choice for elderly patients with atrial fibrillation and presumed cardiac source of </span>emboli<span>. Lowering blood pressure among the elderly is an important aspect of secondary stroke prevention and can be achieved with the same agents used among younger age groups with a preference for a thiazide diuretic/angiotensin-converting enzyme inhibitor combination that has proven efficacy among elderly patients. Available evidence supports the use of statins among elderly patients with history of stroke or transient ischemic attack (TIA), and the derived benefit of </span></span>treatment does not differ significantly from that in the younger age group. Elderly patients with 50% to 99% </span>carotid artery stenosis<span> and history of stroke or TIA should be considered for early carotid endarterectomy to reduce recurrent stroke.</span></p></div><div><h3>Conclusion</h3><p>Age should not be considered a barrier for the provision of optimal secondary prevention interventions. The ava","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 143-152"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29880780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Issues in Pharmacotherapy Research in Older Adults","authors":"Denise Orwig PhD ,&nbsp;Nathaniel M. Rickles PharmD, PhD, BCPP ,&nbsp;Linda Gore Martin PharmD, MBA, BCPS","doi":"10.1016/j.amjopharm.2011.04.008","DOIUrl":"10.1016/j.amjopharm.2011.04.008","url":null,"abstract":"<div><h3>Background</h3><p>The shifting of demographics to an aging society with multiple chronic illnesses<span> and increased heterogeneity has created an undeniable imperative regarding the knowledge about pharmacotherapy<span> in older patients, especially because older adults have a higher rate of medication use compared with the general population. More research on pharmacotherapy in older adults is needed to maximize not only the appropriate use of medications but also the benefits of available treatments in this historically underrepresented group. Investigators face many challenges that may greatly affect the outcomes of research on pharmacotherapy in older adults.</span></span></p></div><div><h3>Objective</h3><p>This commentary discusses the common challenges of research on pharmacotherapy in older adults and provides strategies to overcome such challenges.</p></div><div><h3>Methods</h3><p>The following databases were searched for examples of concepts (dates: 1976–September 14, 2010; key terms: <em>research</em> [in the title]<em>, aged, elderly, older adult,</em> and <span><em>geriatric</em></span>): PubMed, Cumulative Index to Nursing and Allied Health Literature Database (CINAHL), Family &amp; Societal Studies Worldwide, Women's Studies International, Academic Search Premier, Health Source: Academic/Nursing Edition, ISI Web of Knowledge, International Pharmaceutical Abstracts, PsycInfo, and Social Work Abstracts.</p></div><div><h3>Results</h3><p>There are several methodological challenges related to study design, including the measurement of outcomes and the analytical plan; study implementation, such as the recruitment of sites and individuals; the informed-consent process; retention; and other practical considerations. A crucial area to consider is the measurement of medication adherence, both as an independent factor and as a confounder. Many challenges of research in older patients reflect the complexities of the aging process, including psychosocial consequences, and the resultant effects on study participation and outcomes.</p></div><div><h3>Conclusion</h3><p>It is hoped that the recommendations provided will help researchers and clinicians overcome the methodological challenges of conducting research on pharmacotherapy in older adults, thereby fostering more studies that critically evaluate pharmacotherapy and medication-management services and maximizing treatment outcomes in older adults.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 173-189"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29909071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bisphosphonate-Related Subtrochanteric Femoral Fractures","authors":"Indunil Gunawardena MSc, MRCP,&nbsp;Mark Baxter MRCP;,&nbsp;Yama Rasekh MD","doi":"10.1016/j.amjopharm.2011.02.009","DOIUrl":"10.1016/j.amjopharm.2011.02.009","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Hip fractures are important because they are associated with an increased rate of death, substantial morbidity, enormous costs, and devastating effects on independence and </span>quality of life<span>. Bisphosphonates have proven efficacy in reducing the incidence of spine and nonspine fractures. Several case series and multiple individual case reports from around the world suggest that some </span></span>subtrochanteric fractures<span> and those of the femoral shaft<span> might occur in patients who have been treated with long-term bisphosphonate therapy.</span></span></p></div><div><h3>Case Summary</h3><p>We present a case in the United Kingdom, where a patient presented with bilateral, sequential bisphosphonate-related subtrochanteric fractures. Several unique clinical and radiographic features surrounding these atypical fractures that have been identified in the literature are illustrated in this case.</p></div><div><h3>Conclusions</h3><p>There is no rationale for withholding bisphosphonate therapy from patients with osteoporosis<span>, although continued use of bisphosphonates beyond a treatment period of 3 to 5 years should be reevaluated annually. In patients who have been on long-term bisphosphonate therapy, physicians should specifically solicit information of unique clinical features and consider imaging, when appropriate.</span></p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 194-198"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.02.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29798478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Drug-Induced Parkinsonism With Electroconvulsive Therapy","authors":"Maria Andrea Baez MD ,&nbsp;Jonathan Avery MD","doi":"10.1016/j.amjopharm.2011.04.005","DOIUrl":"10.1016/j.amjopharm.2011.04.005","url":null,"abstract":"<div><h3>Background</h3><p>Drug-induced parkinsonism is a common medication side effect.</p></div><div><h3>Objective</h3><p>The present report describes the case of a depressed elderly woman who developed parkinsonism after receiving risperidone<span> and who had improvement of her depression and parkinsonism after electroconvulsive therapy (ECT).</span></p></div><div><h3>Case Summary</h3><p><span><span><span>A 67-year-old white female was admitted to a psychiatry ward for a </span>major depressive episode with psychotic features. The patient developed pronounced parkinsonian features after taking risperidone, which did not improve with discontinuation of the drug, or with </span>benztropine<span><span> and carbidopa/levodopa. A total score of 6 was achieved using Naranjo's adverse drug reaction causality algorithm, suggesting risperidone was a probable cause of this adverse event. The patient's depression and parkinsonian symptoms did not improve until after initiation of ECT. After 19 </span>treatments, the patient had resolution of her depression and only mild </span></span>bradykinesia remained.</p></div><div><h3>Conclusions</h3><p>This was a case of probable drug-induced parkinsonism in an elderly woman who had improvement of her depression and parkinsonism after receiving ECT.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 190-193"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30180040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anorgasmia with Gabapentin May Be Common in Older Patients","authors":"Michael D. Perloff MD, PhD ,&nbsp;David E. Thaler MD, PhD ,&nbsp;James A. Otis MD","doi":"10.1016/j.amjopharm.2011.04.007","DOIUrl":"10.1016/j.amjopharm.2011.04.007","url":null,"abstract":"<div><h3>Background</h3><p><span>Gabapentin is commonly used to treat </span>neuropathic pain<span>, seizures<span>, and bipolar disease in older and elderly patients. It is preferred for its well-tolerated side effect profile. Anorgasmia with gabapentin use is reported, with most cases in young patients.</span></span></p></div><div><h3>Case summary</h3><p><span>This report describes 4 older patients who experienced anorgasmia while taking gabapentin. Of 15 patients initiated on gabapentin in 18 months, 3 male patients aged 73, 76, and 78 years experienced dose-dependent anorgasmia. A fourth case, a 59-year-old female patient, was noted in another clinic. Orgasm returned when gabapentin was reduced or stopped. Although this is not a blinded study, anorgasmia in 3 of 15 patients newly initiated on gabapentin (3 of 11 in those aged &gt;50 years) seems to represent a much higher incidence than the originally reported &lt;1% in epilepsy clinical trials. Outside of </span>erectile dysfunction, clinicians rarely ask older patients about sexual function.</p></div><div><h3>Conclusion</h3><p>Gabapentin-associated anorgasmia may be more common in older patients and appears to be dose dependent.</p></div>","PeriodicalId":50811,"journal":{"name":"American Journal Geriatric Pharmacotherapy","volume":"9 3","pages":"Pages 199-203"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.amjopharm.2011.04.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40101865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}