A study funded by the National Institutes of Health (NIH) has found that antipsychotic use among older adults increases with age, even with no documented clinical psychiatric diagnosis or with a diagnosis of dementia. The results appear in the Journal of Clinical Psychiatry.
Mark Olfson, MD, MPH, of New York State Psychiatric Institute, and colleagues reviewed data on adult antipsychotic prescriptions from the IMS LifeLink LRx Longitudinal Prescription database over 2006–2010. Percentages with short-term (≤30 days) and long-term (≥120 days) use, prescriptions from psychiatrists, use of other psychotropic medication classes, and ICD-9 clinical diagnoses were also assessed.
Overall, women were more likely to be prescribed antipsychotics compared to men and among older patients treated with antipsychotics, about half were long-term users. Patients were also less likely to receive antipsychotics from psychiatrists compared to other clinicians with age (66.2% for ages 20–34 vs. 20.6% for ages 80–84). Among those aged ≥70 who received an antipsychotic in 2009, only about 20% had a mental disorder or dementia diagnosis in that year. Dementia was a common diagnosis in antipsychotic-treated adults aged 75–79 years (37.2%) and 80–84 years (47.8%) who had any mental disorder or dementia diagnoses, despite warnings from the Food and Drug Administration (FDA) that these drugs may increase mortality in dementia patients.
“The results of the study suggest a need to focus on new ways to treat the underlying causes of agitation and confusion in the elderly,” said Dr. Olfson. “The public health community needs to give greater attention to targeted environmental and behavioral treatments rather than medications.”
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