Seniors Increasingly Prescribed Multiple Psychiatric Drugs — Physician’s First Watch

Medical News |
February 14, 2017

Seniors Increasingly Prescribed Multiple Psychiatric Drugs

By Kelly Young

Edited by David G. Fairchild, MD, MPH

The rate of outpatient visits in which seniors are prescribed three or more drugs affecting the central nervous system (CNS) more than doubled over a decade, according to a JAMA Internal Medicine research letter.

Using survey data from office-based physicians, researchers examined how often 98,000 patients aged 65 and older were prescribed three or more CNS medications during a single office visit from 2004 to 2013. The following medications were included: antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonists, tricyclic antidepressants, selective serotonin reuptake inhibitors, and opioids.

On the basis of these data, estimated annual polypharmacy visits in the U.S. increased from 1.5 million to 3.7 million over the study period. The largest increases were seen among rural patients (from 0.7 to 2.2 polypharmacy visits per 100 visits) and among those with a pain diagnosis (0.9 to 2.8 visits per 100 visits).

Of note, the FDA recently required a black-box warning against coprescribing opioids and benzodiazepines because of risks for respiratory depression, coma, and death.

Reader Comments (4)

Deborah May PhD Nurse/NP/PA, Psychiatry, Private psychiatric office

Unfortunately some pts come off inpt psych units liaded on medications and I am faced wiyh trying to slowly taper and dc some meds sliwly so there will be less recidivism. Pts who gave been treated fir psychisis r/t organic changes, then on anticonvulsants such as duvalproex for mgmt if aggression and then gabapentin to decrease anxiety. End up seeing very sedated pt whose cognition Is worsened by anticinvulsants but who needs such because increase if antipsychotic has risk for sudden death or stroke. Complicated folks and good caregivers dealing with approaches that try to keep risks down but ends up prescribing many medications. Not enuf outpt mental health care for elderly at comprehensive mental health centers- need to hane osych comp centers guven budgets that address elderly. WIt until a congressman gets old and has changes and has no caregivers for in-depth psych mental health care- maybe then budgets might incorpoate care for these induvuduals.

Edward Opton Other Healthcare Professional, Other, United States

Are our elders using psychotropic medications to dull their psychological/existential pain IN ADDITION to alcohol, INSTEAD OF alcohol, or both?

We should be looking at the entire spectrum of mind-numbing chemicals, not just the medicines patented by Big Pharma.

thomas f kline md phd Physician, Pediatrics/Adolescent Medicine


Older people can't cope (need more than 8 minutes in an interview)

Older people are a drag on society (give them a pill)

Older people have no use causing depression that needs counseling not enough time - give protocol medication)

This is Pharmacological segregation from mainstream society
same as the new rage: "assisted living" gulags

"not enough resources" - give medication


Richard E.T. Seet Other Healthcare Professional, Health Law/Ethics/Public Policy

After Johnson and Johnson marketed resperidone, it was discovered that the drug encouraged the development of diabetes. So, what's the verdict?

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