Regional differences in psychotropic use among persons with Alzheimer's disease decreased in 2005-2011
University of Eastern Finland News Apr 12, 2017
According to a recent study from the University of Eastern Finland, regional differences in psychotropic use among persons with AlzheimerÂs disease (AD) have decreased.
However, psychotropic use was still very common in 2011. The study included all community–dwellers who received a clinically verified diagnosis of AlzheimerÂs disease in Finland in 2005–2011 and compared the psychotropic drug use in different university hospital districts.
In 2005, altogether 46–51% of persons who were diagnosed with AD in different districts used any psychotropic drug during the first year after the diagnosis. Benzodiazepines and related drugs were the most commonly used psychotropics (26–31%), followed by antidepressants (22–29%).
Antipsychotics were used by 13–18% of persons with AlzheimerÂs disease. The majority of psychotropic use was initiated in the year preceding the AlzheimerÂs disease diagnosis. Approximately 10% of persons who were diagnosed with AlzheimerÂs disease initiated psychotropic use within one year after the diagnosis.
The prevalence and incidence of psychotropic use decreased during the study period and differences between university hospital districts were less evident in 2011 than 2005. The use of psychotropic drugs was still common, as 45–48% of persons who were diagnosed with AlzheimerÂs disease during the previous year used psychotropics in 2011. Psychotropics were more commonly used in those districts where antidementia drug use was less frequent.
These findings are worrying, as psychotropic use increase the risk of adverse events, including death. Further, the evaluation of effectiveness of antidementia drug treatment can be hindered by simultaneous use of psychotropics.
According to guidelines, nonpharmaceutical options should be the first line treatment for behavioural and psychological symptoms of dementia. If psychotropic drugs are initiated, they should be continued only if the symptoms alleviate. Even then, the duration of psychotropic use should be restricted to as short as possible.
This register–based study included all 70,718 community–dwelling persons who received a clinically verified AlzheimerÂs disease diagnosis in Finland in 2005–2011.
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However, psychotropic use was still very common in 2011. The study included all community–dwellers who received a clinically verified diagnosis of AlzheimerÂs disease in Finland in 2005–2011 and compared the psychotropic drug use in different university hospital districts.
In 2005, altogether 46–51% of persons who were diagnosed with AD in different districts used any psychotropic drug during the first year after the diagnosis. Benzodiazepines and related drugs were the most commonly used psychotropics (26–31%), followed by antidepressants (22–29%).
Antipsychotics were used by 13–18% of persons with AlzheimerÂs disease. The majority of psychotropic use was initiated in the year preceding the AlzheimerÂs disease diagnosis. Approximately 10% of persons who were diagnosed with AlzheimerÂs disease initiated psychotropic use within one year after the diagnosis.
The prevalence and incidence of psychotropic use decreased during the study period and differences between university hospital districts were less evident in 2011 than 2005. The use of psychotropic drugs was still common, as 45–48% of persons who were diagnosed with AlzheimerÂs disease during the previous year used psychotropics in 2011. Psychotropics were more commonly used in those districts where antidementia drug use was less frequent.
These findings are worrying, as psychotropic use increase the risk of adverse events, including death. Further, the evaluation of effectiveness of antidementia drug treatment can be hindered by simultaneous use of psychotropics.
According to guidelines, nonpharmaceutical options should be the first line treatment for behavioural and psychological symptoms of dementia. If psychotropic drugs are initiated, they should be continued only if the symptoms alleviate. Even then, the duration of psychotropic use should be restricted to as short as possible.
This register–based study included all 70,718 community–dwelling persons who received a clinically verified AlzheimerÂs disease diagnosis in Finland in 2005–2011.
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