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Psychotropic Drug Use in Korean Patients With Osteoarthritis
Seong-Hun Kang1, Hyun Ah Kim2, Insun Choi3
1Division of Rheumatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Journal of Korean Medical Science
|April 1, 2025
Summary
Many older adults with osteoarthritis (OA) are prescribed psychotropic drugs, even without clear medical need. Opioid and benzodiazepine use decreased, but other psychotropic prescriptions increased, raising safety concerns.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Osteoarthritis (OA) pain management remains challenging, leading to increased off-label psychotropic drug prescriptions globally.
- This study investigates trends in psychotropic medication use among Korean OA patients.
Purpose of the Study:
- To analyze the changes in psychotropic drug prescription patterns for patients diagnosed with hip or knee osteoarthritis between 2011 and 2020.
- To identify specific drug classes and their usage trends in this patient population.
Main Methods:
- Utilized the Korean National Health Insurance Service dataset, including 1,821,158 patients aged 65+ with OA.
- Examined prescription rates (prevalence and long-term use) for various psychotropic drug classes, including opioids, benzodiazepines, anti-epileptics, and antidepressants.
- Stratified analysis based on the presence or absence of psychiatric comorbidities.
Main Results:
- Overall psychotropic prescription prevalence decreased slightly from 58.2% to 52.0% by 2018, then stabilized. Long-term prescription rates showed a slight increase after 2018.
- Opioid and long-acting benzodiazepine prescriptions decreased. However, prescriptions for anti-epileptics and serotonin-norepinephrine reuptake inhibitors (SNRIs) increased in patients with psychiatric comorbidities.
- For patients without psychiatric comorbidities, prescriptions for anti-epileptics, selective serotonin reuptake inhibitors (SSRIs), other antidepressants, and atypical antipsychotics showed an increase. Commonly prescribed drugs included diazepam and alprazolam.
Conclusions:
- A substantial proportion of older Korean adults with OA receive psychotropic medications without a clear indication for their condition.
- The study highlights the use of drugs with limited efficacy for OA pain and potential safety concerns in the elderly population.
- Prescription trends indicate shifts towards certain antidepressants and antipsychotics, even in the absence of diagnosed psychiatric conditions.
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