Despite Safety Concerns, Long-Term Use of Antipsychotics Common in Older Adults

A new report indicates that the use of antipsychotic medications among older adults remains high, despite concerns about the safety of these medications. The results, published in The Journal of Clinical Psychiatry, point to the need for alternative management strategies in older adults with mental disorders and dementia.

The researchers said in a press release that, although antipsychotics are appropriate for the treatment of certain mental disorders, whether these drugs are being used appropriately in older adults was not previously known. The prescription records of adults who filled antipsychotic prescriptions were reviewed. In 2010, the use of antipsychotics appeared to grow more prevalent with increasing age: 2.09% and 1.58% of adults aged 80–84 years and 75–79 years, respectively, used antipsychotics, compared with 1.46% and 0.93% for adults aged 35–39 years and 20–34 years, respectively. Women were more likely than men to use antipsychotics.

Among older adults taking antipsychotic medications who had a mental disorder or dementia diagnosis, the most common diagnosis was dementia (66.2% of those aged 75–79 years and 47.8% of those aged 80–84 years). However, more than three-quarters of older adults given a prescription for antipsychotics had no documented diagnosis of a mental disorder or dementia.

When the researchers looked at long-term versus short-term use of antipsychotic medications, they found that 53.7%, 49.2%, and 46.2% of older antipsychotic users aged 70–74 years, 75–79 years, and 80–84 years, respectively, used the medications for longer than 120 days.

The study also revealed that the percentage of antipsychotic drug users who had received a prescription for the medication from a psychiatrist decreased with age, from 66.2% of those aged 20–34 years to 20.6% of those aged 80–84 years (https://bit.ly/1QsY7qs).

The study’s findings are alarming, given the safety warnings from the US Food and Drug Administration that antipsychotic medications can increase the risk of death in older adults with dementia. Other serious side effects associated with the drugs include stroke and kidney damage.

The study’s lead author, Mark Olfson, MD, MPH, Columbia College of Physicians and Surgeons, New York, NY, said in a press release, “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.”—Kara Rosania