In an article in the latest edition of the Australian and New Zealand Journal of Psychiatry, the research team highlighted “very high levels of psychotropic drug prescribing among older people, particularly older women and those over 80 years of age”.
The team, which included psychiatrists and public health researchers, called for an urgent review of prescribing practices, due to “substantial doubts” about effectiveness and safety.
The article drew together findings from separate studies of three major classes of psychotropics – antipsychotics, antidepressants, and anxiolytic, hypnotic and sedative (AHS) drugs – using Medicare Australia data during the 2000s.
“This issue is of growing concern, given the increasing size of the elderly population and the greater vulnerability of older people to adverse effects of drugs and to interactions from multiple drugs that are often being prescribed,” said Associate Professor Gerard Byrne, UQ’s Head of Psychiatry.
The article also highlighted the high financial cost of the drugs – AUD702 million in 2007 – 2008, which is more than the Medical Benefits Scheme costs for all mental health services combined.
“We consider the current level of psychotropic prescribing for older Australians, there is a pressing need to know more about the epidemiology, sociology and optimal use of medicines that in many cases may be unnecessary, costly or potentially harmful, “ Associate Professor Byrne said.
ABOUT PSYCHOTROPIC DRUG USE
Antipsychotics (such as olanzapine and risperidone) – Despite increasing questions surrounding the risks and benefits of use in the elderly, there has been an increase in their use in some aged care facilities, albeit at low doses.
Antidepressants (such as SSRIs and venlafaxine) –While depressive symptoms are common in people with dementia and among those in residential aged care facilities, the effectiveness of antidepressants in these groups is not established.
Anxiolytics, hypnotics and sedatives (such as benzodiazepine and temazepam) – Patterns of use are inconsistent with recommendations for short-term use and the evidence that there is lower rates of anxiety disorders in older age groups. AHS use in older people is associated with cognitive impairment, delirium and an increased risk of falls and accidents.
Read the full article online.
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