Psychotropic polypharmacy impairs walking independence in post-stroke patients

Area of Science:

• Geriatric Medicine
• Neurology
• Pharmacology

Background:

• Psychotropic medications are frequently used in older adults and linked to adverse outcomes.
• Limited evidence exists on the impact of psychotropic use on walking ability in post-stroke patients.

Purpose of the Study:

• To investigate the association between psychotropic medication use and walking independence in patients following a stroke.

Main Methods:

• Retrospective cohort study of 559 stroke patients undergoing rehabilitation.
• Recorded psychotropic medications (benzodiazepines, hypnotics, antipsychotics, antidepressants) at admission.
• Assessed walking independence at discharge using Functional Independence Measure (FIM) walk score (≥6) and logistic regression analysis.

Main Results:

• 25.4% of patients used psychotropic drugs at admission.
• Increased number of psychotropic medications was independently associated with lower walking independence (OR 0.620, P=0.011).
• Hypnotic use showed a significant negative impact on walking independence (OR 0.331, P=0.004).

Conclusions:

• Psychotropic polypharmacy, particularly with hypnotics, at admission is associated with a reduced likelihood of achieving walking independence post-stroke rehabilitation.
• Judicious use of psychotropic medications is recommended for older post-stroke patients aiming for ambulation goals.