PRESCRIBING PATTERNS FOR PSYCHOTROPIC DRUGS

Suicide rates in the elderly have declined in many countries in recent years. This decline has been reported to be associated with increased prescribing of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), antipsychotics and antimanic drugs and reduced prescribing of barbiturates, hypnotics and sedatives. This study examined the relationship between prescribing patterns of individual psychotropic drugs and suicide rates by specific methods of elderly suicides. There was a negative correlation between the prescription of tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics, antimanic drugs and non-opiate analgesics and a decline in elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. There was a positive correlation between the prescription of barbiturates, hypnotics and sedatives and elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. This study demonstrated that changes in prescribing patterns of individual psychotropic drugs do influence elderly suicide rates of the commonly used methods of suicide and suggest that this may be due to more accurate diagnostic-specific prescribing of psychotropic drugs.

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Psychotropic drug use in relation to mental disorders and institutionalization among 95-year-olds: a population-based study

International Psychogeriatrics ◽

10.1017/s1041610211000524 ◽

2011 ◽

Vol 23 (8) ◽

pp. 1270-1277 ◽

Cited By ~ 5

Author(s):

Eva Lesén ◽

Anders Carlsten ◽

Ingmar Skoog ◽

Margda Waern ◽

Max Petzold ◽

...

Keyword(s):

Drug Use ◽

Mental Disorders ◽

Psychotropic Drug ◽

Psychotropic Drugs ◽

Psychotic Disorders ◽

Rating Scale ◽

The Elderly ◽

Population Based ◽

Prescribing Patterns ◽

Psychotropic Drug Use

ABSTRACTBackground: The prevalence of psychotropic drug use is high among the elderly, but research on how psychotropic drugs are used among individuals aged 90 years and older is limited. An increased knowledge on this topic may contribute to improved prescribing patterns in this vulnerable population. The aim of this study was to assess the use of psychotropic drugs in relation to mental disorders and institutionalization among 95-year-olds and to identify use of potentially inappropriate psychotropic drugs.Methods: All 95-year-olds born in 1901–1903 living in nursing homes or community settings in Gothenburg, Sweden were invited to participate. The response rate was 65% and 338 95-year-olds were examined (263 women, 75 men). Psychotropic drug use in relation to mental disorders and institutionalization was assessed. Information on drug use was collected primarily from multi-dose drug dispensing lists. Participants were examined by trained psychiatrists using the Comprehensive Psychopathological Rating Scale and a battery of cognitive tests. Dementia, depression, anxiety and psychotic disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R).Results: Sixty percent of the 95-year-old participants used psychotropic drugs; hypnotics were most common (44%). Potentially inappropriate psychotropics were observed in one third (33%). Antidepressants were used by 7% of the participants without dementia who fulfilled criteria for a depressive disorder, while 56% used hypnotics and 30% used anxiolytics.Conclusions: The high prevalence of psychotropic drug use and the nonspecific nature of these treatments among 95-year-olds indicate a need for improvement in prescribing patterns.

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Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyaa005 ◽

2020 ◽

Vol 23 (5) ◽

pp. 300-310

Author(s):

E di Giacomo ◽

A Stefana ◽

V Candini ◽

G Bianconi ◽

L Canal ◽

...

Keyword(s):

Aggressive Behavior ◽

Psychotropic Drugs ◽

Rating Scale ◽

Violent Behavior ◽

Prescribing Patterns ◽

Overt Aggression ◽

History Of ◽

Axis I ◽

Overt Aggression Scale

Abstract Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

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Longitudinal prescribing patterns of psychotropic drugs in nursing home residents.

Experimental and Clinical Psychopharmacology ◽

10.1037/1064-1297.4.2.224 ◽

1996 ◽

Vol 4 (2) ◽

pp. 224-233 ◽

Cited By ~ 4

Author(s):

Jiska Cohen-Mansfield ◽

Steve Lipson ◽

Ann L. Gruber-Baldini ◽

Jeanne Farley ◽

Raymond Woosley

Keyword(s):

Nursing Home ◽

Psychotropic Drugs ◽

Nursing Home Residents ◽

Prescribing Patterns

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The Prevalence and Patterns of Combined Psychotropic Polypharmacy among Acute Care Hospitals in Japan

10.1101/649012 ◽

2019 ◽

Author(s):

Sayuri Shimizu ◽

Yasuyuki Okumura ◽

Koichi B. Ishikawa ◽

Shinya Matsuda ◽

Hiroto Ito ◽

...

Keyword(s):

Cancer Patients ◽

Acute Care ◽

Psychotropic Drugs ◽

Gastrointestinal Cancer ◽

Antipsychotic Drugs ◽

Acute Care Hospitals ◽

Prescribing Patterns ◽

Stroke Patients ◽

Upper Gastrointestinal Cancer ◽

Upper Gastrointestinal

ABSTRACTPurposeTo evaluate the prescribing patterns of psychotropic polypharmacy for inpatients of acute care hospitals in Japan.MethodsAdministrative data on 2,639,885 patients admitted to acute care hospitals in Japan between July and December of 2008 were analyzed retrospectively. We defined psychotropic medications as antipsychotics, antidepressants, benzodiazepines, and other sedatives/hypnotics and studied their prescription patterns during the hospitalization of patients with stroke, acute cardiac infarction, cancer, and diabetes mellitus.ResultsAt least one psychotropic drug was prescribed in 35.9% of all cases. Two-drug combinations of antipsychotic drugs were prescribed for stroke patients in 14,615 cases (1.4%), more than 2 in 3,132 cases (0.3%), and 22.4% of cases were prescribed 2 or more psychotropic drugs in addition to antipsychotic drugs. Amongst upper gastrointestinal cancer patients, 7.7% were prescribed a combination of 2 or more drugs, including benzodiazepines. Of the upper gastrointestinal cancer patients who were prescribed benzodiazepines, 20.3% were also prescribed 2 or more psychotropic drugs. Amongst stroke and upper gastrointestinal cancer patients, 36.6% and 35.6%, respectively, were treated with combination therapy using drugs of this class and others.ConclusionThere is a pattern of polypharmacy that combines benzodiazepines and other sedatives/hypnotics with antidepressants or antipsychotic drugs, and this study provides a detailed analysis of this within acute care hospitals. Our results indicate the need for additional research into the efficacy of polypharmacy for inpatients in non-psychiatric settings.

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Prescription Patterns of Anti-dementia and Psychotropic Drugs in People Living With Dementia in China

Innovation in Aging ◽

10.1093/geroni/igab046.2444 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 649-650

Author(s):

Zhang Yingyang ◽

Hao Luo ◽

Gloria H Y Wong ◽

Terry Y S Lum ◽

Celine Chui ◽

...

Keyword(s):

Psychotropic Drugs ◽

Clinical Symptoms ◽

Anatomical Therapeutic Chemical ◽

Drug Prescription ◽

Prescribing Patterns ◽

Prescription Patterns ◽

Factors Associated ◽

Tertiary Hospitals ◽

Functioning Level ◽

Critical Intervention

Abstract Pharmacotherapy of dementia is a critical intervention for managing symptoms of and slowing progression of dementia. However, evidence on prescribing patterns of dementia medications and their associated factors in China is lacking. This study aimed to examine prescribing rates of anti-dementia and psychotropic drugs, and investigate factors associated with prescription of anti-dementia drugs and its co-prescription with psychotropic drugs in China. We used data from the Clinical Pathway for Alzheimer’s Disease in China study, an eight-week multi-center registry study that was conducted in tertiary hospitals between Nov 12, 2012, and Jan 31, 2013. Anti-dementia and psychotropic drugs were coded according to the Anatomical Therapeutic Chemical codes. Logistic regressions were performed to examine factors associated with prescription patterns after controlling for demographic and clinical characteristics of people living with dementia and caregivers’ characteristics. A total of 746 participants were included in this study, of which almost 80% of participants were prescribed anti-dementia drugs, and one-third were prescribed at least one psychotropic drug. The concomitant prescription rate of anti-dementia and psychotropic drugs was 24·3%. Logistic regression results showed that first consultation, dementia subtypes, dementia severity, functioning level, and having symptoms of psychosis and apathy were significantly associated with anti-dementia drug prescription. Frontotemporal dementia, worse functioning level, psychosis, agitation, and depression were significantly associated with co-prescription of anti-dementia and psychotropic agents. Practices of dementia prescriptions generally concurred with clinical guidelines in tertiary hospitals in China, while prescription of anti-dementia and psychotropic medications mainly depended on clinical symptoms of patients with dementia.

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