This article reviews a number of neuroanatomic and neurochemical changes that occur in the brain with aging, and focuses specifically on those that may affect the response to psychotropic drugs. We hope to increase physicians' awareness of these “central,” or brain, changes, that occur with aging when prescribing and monitoring psychotropic use, since the traditional emphasis in prescribing for the elderly has rested with the review of pharmacokinetic, or “peripheral” organ changes.
Get full access to this article
View all access options for this article.
References
1.
ThompsonT. L.IIMoranM. G., and NiesA. S., Psychotropic Drug Use in the Elderly, Koch-WeserJ. (ed.), Medical Intelligence Drug Therapy, New England Journal of Medicine, 308, pp. 134–138, 194–199, January 20 and January 27, 1983.
2.
CusackB.KellyJ.O'MalleyK.NoelJ.LavanJ., and HorganJ., Digoxin in the Elderly: Pharmacokinetic Consequences of Old Age, Clinical Pharmacology and Therapeutics, 25, pp. 772–776, 1979.
3.
ShaderR. I. and GreenblattD. J., Pharmacokinetics and Clinical Drug Effects in the Elderly, Psychopharmacology Bulletin, 15: 2, pp. 8–14, 1979.
4.
WisniewskiH. and TerryR. D., An Experimental Approach to the Morphogenesis of Neurofibrillary Degeneration and the Argyrophilic Plaque, in Alzheimer's Disease and Related Conditions, WolstenholmeG. E. W. and O'ConnorM. (eds.), J & A Churchill, London, England, pp. 223–248, 1970.
5.
BrizzeeK. R.HarkinJ. C.OrdyJ. M., and KaackB., Accumulation and Distribution of Lipufuscin, Amyloid, and Senile Plaques in the Aging Nervous System, in Aging, Volume 1, BrodyH.HarmanD., and OrdyJ. M. (eds.), Raven Press, New York, pp. 39–78, 1975.
6.
ScheibelM. E. and ScheibelA. B., Structural Changes in the Aging Brain, in Aging, Volume 1, BrodyH.HarmanD., and OrdyJ. M. (eds.), Raven Press, New York, pp. 11–37, 1975.
7.
TomlinsonB. E. and HendersonG., Some Quantitative Cerebral Findings in Normal and Demented Old People, in Aging: Neurobiology of Aging, Volume 3, TerryR. D. and GershonS. (eds.), Raven Press, New York, pp. 183–204, 1976.
8.
StrehlerB. L., Molecular and Systemic Aspects of Brain Aging: Psychobiology of Informational Redundancy, in Aging: Neurobiology of Aging, Volume 3, TerryR. D. and GershonS. (eds.), Raven Press, New York, pp. 281–311, 1976.
9.
HenleyK. and MorrisonA. R., A Re-evaluation of the Effects of Lesions of the Pontine Tegmentum and Locus Coeruleus on Phenomena of Paradoxical Sleep in the Cat, Acta Neurobiol Exp, 34, pp. 215–232, 1974.
10.
KorfJ.AghajanianG., and RothR., Increased Turnover of Norepinephrine in the Rat Cerebral Cortex During Stress: Role of the Locus Coeruleus, Neuropharmacology, 12, pp. 933–938, 1973.
11.
YakovlevP. I. and LecoursA. R., The Myelogenetic Cycles of Regional Maturation of the Brain, in Regional Development of the Brain in Early Life, MinkowskiA. (ed.), Blackwell Scientific Publications, Oxford and Edinburgh, England, pp. 3–70, 1967.
12.
MagounH. W., The Waking Brain, Charles C. Thomas, Springfield, Illinois, 1958.
13.
IngvarD. H. and LassenN. A., Brain Work: The Coupling of Function, Metabolism and Blood Flow in the Brain, Academic Press, New York, 1975.
14.
ObristW. D., Cerebral Blood Flow and Its Regulation, Clinical Neurosurgery, 22, pp. 106–116, 1975.
15.
PrinzP.ObristW., and WangH., Sleep Patterns in Healthy Elderly Subjects: Individual Differences as Related to Other Neurobiological Variables, in Sleep Research, ChaseM.SternW., and Walters ? (eds.), Brain Information Service/Brain Research Institute, UCLA, Los Angeles, California, 1975.
16.
GottfriesC. G.RoosB. E., and WinbladB., Monoamine and Monoamine Metabolites in the Human Brain Post-mortem in Senile Dementia, Akta Gerontologia, 6, pp. 429–435, 1976.
17.
McGeerE. and McGeerP. L., Neurotransmitter Metabolism in the Aging Brain, in Aging: Neurobiology of Aging, Volume 3, TerryR. D. and GershonS. (eds.), Raven Press, New York, pp. 389–403, 1976.
18.
RobinsonD. S., Changes in Monoamine Oxidase and Monoamines with Human Development and Aging, Federation Proceedings, 34: 1, pp. 103–107, Janaury 1975.
19.
GottfriesC. G.GottfriesI.JohanssonB., Acid Monoamine Metabolites in Human Cerebrospinal Fluid and Their Relations to Age and Sex, Neuropharmacology, 10: 6, pp. 665–672, 1971.
20.
RobinsonD. S.DavisJ. M.NiesA.RavarisC. L., and SylwesterD., Relation of Sex and Aging to Monoamine Oxidase Activity of Human Brain, Plasma, and Platelets, Archives of General Psychiatry, 24: 6, pp. 536–539, June 1971.
21.
BertlerA., Occurrence and Localization of Catecholamines in the Human Brain, Acta Physiologica Scandinavica, 51, pp. 97–107, February-March, 1961.
22.
RobinsonD. S.NiesA.DavisJ. N., Ageing, Monoamines, and Monoamine-Oxidase Levels, Lancet, 1: 745, pp. 290–291, February 5, 1972.
23.
BurnsJ.BohdaneckyZ., and WeissT., Physostigmine Induced Hippocampal Theta Activity in Learning in Rats, Psychopharmacologia, 3, pp. 254–263, 1962.
24.
DrachmanD. A., Central Cholinergic System and Memory, Psychopharmacology: A Generation of Progress, LiptonM. A.DiMascioA., and KillamK. F. (eds.), Raven Press, New York, pp. 651–652, 1978.
25.
BowenD. M.SmithC. B.WhiteP., and DavisonA. N., Neurotransmitter-Related Enzymes and Indices of Hypoxia in Senile Dementia and Other Abiotrophies, Brain, 99: 3, pp. 459–496, 1976.
26.
VaskoM. R.DominoL. E., and DominoE. F., Differential Effects of d-Amphetamine on Brain Acetylcholine in Young, Adult and Geriatric Rats, European Journal of Pharmacology, 27: 1, pp. 145–147, June 1974.
27.
MeekJ. L.BertilssonL.CheneyD. L.ZsillaG., and CostaE., Aging-Induced Changes in Acetylcholine and Serotonin Content of Discrete Brain Nuclei, Journal of Gerontology, 32, pp. 129–132, 1977.
28.
McGeerP. L.McGeerE. G., and SuzukiJ. S., Aging and Extrapyramidal Function, Archives of Neurology, 34: 1, pp. 33–35, January 1977.
29.
FrolkisV. V.BezrukovV. V.DuplenkoY. K.ShchegolevaI. V.ShevtchukV. G., and VerkhratskyN. S., Acetylcholine Metabolism and Cholinergic Regulation of Functions in Aging, Gerontologia, 19: 1, pp. 45–57, 1973.
30.
LaiH. and CarrollP. T., Alterations in Brain Neurotransmitter Systems Related to Senescence, in Geriatric Psychopharmacology, NandyK. (ed.), Elsevier/North-Holland, New York, pp. 3–15, 1979.
31.
BuckS. H.BurksT. F., and YamamuraH. I., Neuropeptide Alterations in the Central Nervous System in Aging, Gerontologia, 28: 1, pp. 25–34, 1982.
32.
SamorajskiT., Neurochemical Changes in the Aging Human and Non-human Primate Brain, in Psychopharmacology of Aging, EisdorferC. and FannW. E. (eds.), SP Medical and Scientific Books, New York, pp. 145–168, 1980.
