Safety of pharmacotherapy in the elderly patients with psychiatric diseases

Aim

To evaluate the prescription rates of potentially inappropriate medications for elderly patients receiving treatment in apsychiatric inpatient setting.

Material and methods

We studied medical records of 250 patients over 65 years of age using the STOPP/START criteria.

Results

A total of 490 prescriptions of potentially inappropriate medications were detected, including administration of neuroleptics and benzodiazepines that predictably increase the risk of falls (56.7%), phenothiazines as a first-line pharmacotherapy, central anticholinergic drugs for thetreatment of extrapyramidal adverse effects associated with the use of neuroleptics. Up to one third of patients with dementia (30.6%) were treated with non-recommended medicines affecting the central nervous system. Concomitant administration of at least two drugs with antimuscarinic/anti-cholinergic properties was found in 6.3% of patients.

Conclusion

The pharmacoepidemiological analysis revealed high frequency of prescription of potentially inappropriate medications for patients over 65 years of age treated in apsychiatric inpatient setting. The use of the STOPP/START criteria in a psychiatric setting may be beneficial to avoid polypharmacy and decrease the incidence of adverse drug reactions

Key words

Potentially inappropriate medications, polypharmacy, adverse drug reactions, elderly, mental disorders, STOPP/START criteria.