Health Day Reporter
Wednesday, March 10, 2021 (HealthDay News)-Many older people dementia Dangerous combinations of drugs that increase the risk of Overdose, Fall, and even more mental deterioration, new research has been discovered.
Approximately one in seven people with dementia living outside a nursing home are taking three or more medications. Brain and nervous system, The researchers reported.
Opioids pain, But they carry the US Food and Drug Administration-need a black box warning of overdose and death if they are taken together Benzodiazepine, Antipsychotics and antiepileptic drugs, said Most.
“About half of the top 20 combinations included opioids and other CNS depressants,” he said.[centralnervoussystemdepressantmedications”hesaid”[centralnervoussystemdepressantmedications”hesaid
In this study, Must and his colleagues analyzed 2018 Medicare prescribing data for more than 1.2 million people with dementia, with a particular focus on drugs that act on the central nervous system.
Researchers said people over the age of 65 should not be prescribed more than one CNS active drug at the same time, as drug interactions can be potentially dangerous.
Nonetheless, nearly 14% of people with dementia have been taking three or more CNS active drugs at the same time for at least a month.
About 58% of the group have been taking at least three duplicate medications for more than half a year, and 7% have been taking them year-round, Must said.
The most common combination included at least one antidepressant, one antiepileptic drug, and one antipsychotic, Must said.
Very often, these drugs are prescribed for purposes other than their function, the researchers said.
For example, the most commonly prescribed drug overall was gabapentin. This is an antiepileptic drug that is often prescribed off-label to treat pain. This accounted for one-third of the total number of prescription days patients received in 2018.
And at least 47% of people taking three or more medications are taking at least one antipsychotic, which is often prescribed to people with dementia because of agitation and insomnia.
Of the 10 patients taking 3 or more drugs, more than 9 were taking antidepressants and nearly two-thirds were taking antiepileptic drugs.
The problem is that taking these drugs in combination poses a higher risk to the patient than it benefits.
“For most of these drugs, the evidence that they work is pretty slim,” Must said. “On the other hand, there is plenty of evidence that there are risks associated with them.”
For example, drugs that act on the brain and nervous system increase the risk of severe falls.
“Almost all of these drugs are associated with falls and increased injuries associated with falls, which can have catastrophic consequences for older people,” continued Must.
There is also some evidence that antidepressants and antipsychotics may actually contribute to amnesia and reasoning in people with dementia.
“Obviously, for people with dementia, it’s very worrisome to give them drugs that actually seem to worsen their cognition,” Must said.
“One of my favorites is trying to stop the medicines people are taking, as people can take different medicines,” said Mouthto, a geriatric psychiatrist. Stated.
His team released the findings on March 9th Journal of American Medical Association.
Dr. Howard Philit, Founding Executive Director and Chief Science Officer of the Alzheimer’s Disease Drug Discovery Foundation, said physicians treating the elderly should undergo regular medication reviews. He was not part of a new study.
“Every time I see a new patient, I always ask them to empty the medicine rack, put it in a bag and bring it to my office. We put it on my table and put it all together. Passing through. Philit, a clinical professor of geriatrics at Mount Sinai School of Medicine in New York City, said:
“It can be very complicated,” Philit continued. “I took the drug 5 or 10 years ago and sometimes I don’t even know why I’m taking it. Sometimes I’m taking the same drug from two different doctors, and the doctors say the patient is taking it. I don’t know what I’m doing. Drug replication. “
According to Morst, medication reviews ensure that people with dementia receive health-critical medications while reducing the risk of harm.
“It’s important to note that there is definitely concern that older people’s pain is not well treated,” says Must. “For people with dementia who are concerned about their behavior, they may be experiencing pain that cannot be clearly expressed. It is very important to treat their pain. So my question is, What are the reasons for other medications? “On?”
For more information
At the National Institute on Aging, Medication management for patients with Alzheimer’s disease..
Source: Donovan Maust, MD, Associate Professor, Psychiatry, Michigan Medicine; Doctor of Medicine Howard Philit, Founding Secretary-General and Chief Scientific Officer of the Alzheimer’s Disease Drug Discovery Foundation, Geriatrics and Palliative Care at Mount Sinai School of Medicine, New York City Clinical professor. Journal of American Medical Association, March 9, 2021
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