Research in the Journal of the American Geriatrics Society states that older adults have far higher rates of psychotropic use compared to younger adults, but they are also less likely to receive psychotherapy or care from psychiatrists. This could indicate that older adults may be at risk for adverse drug effects from multiple medications when they could benefit from therapy-oriented approaches instead.
Donovan T. Maust, MD, MS, from the University of Michigan Medical School, and colleagues analyzed data from the data from the National Ambulatory Medical Care Survey (NAMCS) on visits to office-based physicians in the United States from 2007–2010. Survey data included information on visits where patients received a mental health diagnosis, saw a psychiatrist, received psychotherapy, and/or received a prescription or renewal of a psychotropic medication (eg, antidepressants, anxiolytics, antipsychotics, mood stabilizers, and stimulants). Patients were categorized as younger adults (aged 18–64) or older adults (aged ≥65).
Older adults had nearly double the rate of visits related to antidepressants and anxiolytics compared to younger adults, but visited psychiatrists at half the rate of younger adults. Older adults were also significantly less likely to receive psychotherapy compared to younger adults. Depression and anxiety were the most common diagnoses at psychotropic visits for both age groups but older adults had a larger proportion of visits with a dementia diagnosis.
Particularly for mild depression and anxiety, psychotherapy may be a safer alternative than psychotropic treatment for older adults, especially those taking multiple medications, the authors noted.
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