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Current psychotropic medication prescribing patterns in late-life bipolar disorder
Soham Rej1, Nathan Herrmann1, Kenneth Shulman1
1Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
International Journal of Geriatric Psychiatry
|December 3, 2016
Summary
Older adults with bipolar disorder often receive multiple psychotropic medications, frequently not aligning with treatment guidelines. This prescribing pattern in late-life bipolar disorder may increase risks for adverse health outcomes.
Area of Science:
- Geriatric Psychiatry
- Pharmacology
- Clinical Psychology
Background:
- Bipolar disorder affects a growing elderly population.
- Evidence-based psychotropic treatment in this demographic is not well understood.
- Assessing current prescribing practices is crucial for optimizing care.
Purpose of the Study:
- To describe psychotropic prescribing patterns in Canadian older adults with bipolar disorder.
- To evaluate adherence to evidence-based treatment guidelines in late-life bipolar disorder.
Main Methods:
- Population-based, cross-sectional study.
- Included 1443 bipolar disorder patients aged 66+ in Ontario, Canada.
- Analyzed psychotropic medication prescriptions within 30 days post-psychiatric hospitalization.
Main Results:
- High prevalence of polypharmacy (≥2 psychotropic medications) at 81.5%.
- Atypical antipsychotics (75.3%) and benzodiazepines/zopiclone (42.3%) were most common.
- Underutilization of lithium monotherapy (1.4%) and atypical antipsychotic monotherapy (15.7%) was observed.
Conclusions:
- Older adults with bipolar disorder are frequently prescribed multiple psychotropic medications upon discharge.
- Prescribing practices often deviate from bipolar treatment guidelines, potentially risking patient health.
- Future research should explore protocolized treatment to enhance safety and effectiveness in late-life bipolar disorder.
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