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Anticonvulsant use in elderly patients in long-term care units
S Timmons1, F McCarthy, J Duggan
1Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland. suzannetimmons@hotmail.com
Background:
Elderly patients in long-term care units are frailer than their community-dwelling peers and may be more at risk from toxic side-effects of anticonvulsant medication at standard doses.
Aim:
To examine the prescribing of anticonvulsants to patients in elderly care units.
Methods:
Drug prescription sheets and case notes were reviewed. Serum anticonvulsant concentration, renal and liver profiles and albumin level were measured.
Results:
Anticonvulsants were prescribed to twice as many male as female patients (32 vs 14%; p<0.03) and to 33% of those younger than 80 years of age versus 10% of those aged 80 years or older (p<0.0002). No patient had significant hypoalbuminaemia and routine measurement of serum anticonvulsant concentration did not indicate an alteration of dosage.
Conclusions:
Anticonvulsants appear to be well tolerated in these patients. The younger age of those receiving anticonvulsants is inadequately explained by the characteristics of the patient cohort and may reflect a shift towards a younger age in patients requiring anticonvulsants due to increased mortality in this group.