Medications prescribed for patients with serious mental illness (SMI) include several categories with safety warnings, which require either special consideration for use or close monitoring. Guidelines exist to assist clinicians to optimize medication selection for older adults, aiding in prevention of common adverse drug events among the elderly. In this session, you will learn best practices for safety considerations for use of psychotropic medications in older adults. The American Geriatrics Society (AGS) released 2019 updates to the Beers Criteria for Potentially Inappropriate Medication (PIM) use in older adults, and the previous update was released in 2015. The AGS medication recommendations include medications to use with caution, those to examine in relationship to common disease states, as well as medications in comparison for potential medication interactions. These guidelines will be outlined in the context of standard psychiatric practices. Discussion of periodic review of all medications, de-prescribing, and alternatives will also be included.

Learning Objectives

• Identify potentially inappropriate psychotropic medication for use in older adults, allowing for close inspection of benefits and harms among drug categories prescribed for patients with serious mental illness
• Describe pharmacodynamics and pharmacokinetics warranting special considerations when prescribing psychotropic medications for older adults in order to prevent adverse drug events
• Examine safety considerations, including patients’ reasonable use of poly-pharmacy, de-prescribing, and use of alternatives for management of psychiatric issues when appropriate

Target Audience

Nurse/Nurse Practitioner; Pharmacist, Psychiatrist; Physician (Non-psychiatrist); Physician Assistant; 

Instructional Level

Intermediate; Advanced

Estimated Time to Complete

Estimated Duration: 1.25 hours 
Program Start Date: April 11, 2019
Program End Date: April 11, 2022

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course, including the evaluation. A multiple choice quiz is provided based on the content. A passing score of 75% must be achieved. Retakes are available for the test. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.

Continuing Education Credit

Physicians

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The APA designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Presenter/Planner 

• Donna Rolin, PhD, APRN. University of Texas at Austin. Reports no financial relationships with commercial interests. 

Planners

• John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose. (Reviewed on 4/11/22) 
• Teri Brister, PhD, LPC, National Alliance on Mental Illness. Dr. Brister has no relevant financial relationships to disclose. (Reviewed on 4/12/22)

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact SMIAdviserHelp@psych.org for technical assistance