Antipsychotic Use in Elderly, Prescribing Rates Examined

FDA warning leads to decreased use of the drugs among elderly patients with dementia
By A. Agrawal, PhD
HealthDay Reporter

FRIDAY, Jan. 15 (HealthDay News) -- Elderly patients newly admitted to nursing homes are more likely to be prescribed antipsychotics if the nursing home has a high prescribing rate for antipsychotics, according to a study in the Jan. 11 Archives of Internal Medicine. A related study determined that an FDA advisory on the use of atypical antipsychotics in elderly dementia patients resulted in decreased use.

Yong Chen, M.D., from the University of Massachusetts Medical School in Worcester, and colleagues assessed factors associated with antipsychotic prescribing in 16,586 newly admitted nursing home residents. They found that more than 29 percent of residents received at least one antipsychotic medication, even though 32 percent of them had no clinical indication for the medication. After adjusting for potential clinical indications, the likelihood of receiving medication was higher for residents in nursing homes with the highest antipsychotic prescribing rates than the lowest rates (risk ratio, 1.37).

E. Ray Dorsey, M.D., from the University of Rochester Medical Center in New York, and colleagues examined the impact of the U.S. Food and Drug Administration advisory issued in April 2005 regarding the risks of atypical antipsychotic use in elderly patients with dementia. They found that annual atypical antipsychotic drug mentions increased by 34 percent overall and by 16 percent in patients with dementia in the two years before the advisory. In the year following the advisory, atypical antipsychotic drug mentions fell by 2 percent overall and by 19 percent in those with dementia.

"Ensuring drug safety in elderly people will require the collaborative effort of researchers, regulators, manufacturers, professional organizations, and health care provider organizations to send the right message to prescribers," write the authors of an accompanying commentary.

Two authors of the second study reported consulting and financial relationships with pharmaceutical companies.

Abstract - Chen
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Abstract - Dorsey
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