A 79-year-old woman with generalized anxiety disorder and mild hepatic impairment (Child-Pugh class A) is referred to the PMHNP after her primary care provider noted persistent anxiety despite behavioral interventions. Her current medications include lisinopril, metformin, and a low-dose aspirin. Liver function tests reveal mildly elevated transaminases (AST 52, ALT 58) with albumin of 3.2 g/dL. She reports that a friend of hers had a 'bad reaction' to a psychiatric medication and she is worried about side effects. The PMHNP considers age-related pharmacokinetic changes when selecting an anxiolytic agent. Which of the following most accurately describes the pharmacokinetic considerations for psychotropic prescribing in elderly patients with reduced hepatic function?