Antiseizure, antidepressant, and antipsychotic medication prescribing in elderly nursing home residents

Sai Praneeth R Bathena, Ilo E. Leppik, Andres M Kanner, Angela K. Birnbaum

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective The incidence of epilepsy is highest in the elderly and the prevalence of epilepsy is higher in nursing home residents than in other cohorts. Co-medications that act in the central nervous system (CNS) are frequently prescribed in this population. The objective was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of use of antipsychotic and antidepressant medications in elderly nursing home residents receiving ASDs. Methods Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes. Prescribing information was available on ASD, antidepressant, and antipsychotic drugs on one day in October 2013. The frequency distribution by age, formulation, trademarked/generic drugs, route of administration, and multiple drug combinations were determined. Results Overall, 66.8% of 18,752 residents received at least one CNS-active drug as classified by the Generic Product Identifier classification system. For those 65 years and older, ASDs were prescribed for 14.3% residents. Gabapentin comprised 7.3%; valproate 3.0%; levetiracetam 1.8%; and phenytoin 0.9%. An antidepressant was used in 64.2% of persons prescribed an ASD. Antidepressant use varied for specific ASDs and ranged from 50 to 75%. An antipsychotic medication was used in 30% of persons prescribed an ASD and ranged from 16.8 to 54.2% for specific ASDs. Both antidepressant and antipsychotic use occurred in 22.2% of persons prescribed an ASD, respectively. Significance The pattern of CNS-active drug use has changed from previous years in this geographic region. Use of phenytoin has declined markedly, but antidepressant use has increased substantially. The CNS side effect profile of these medications and the possible long-term consequences in this population can greatly complicate their therapy.

Original languageEnglish (US)
Pages (from-to)116-120
Number of pages5
JournalEpilepsy and Behavior
Volume69
DOIs
StatePublished - Apr 1 2017

Fingerprint

Nursing Homes
Antidepressive Agents
Antipsychotic Agents
Pharmaceutical Preparations
Central Nervous System Agents
etiracetam
Phenytoin
Epilepsy
Central Nervous System
Generic Drugs
Age Distribution
Valproic Acid
Drug Combinations
Population
Databases
Incidence

Keywords

  • Antidepressant
  • Antipsychotic
  • Antiseizure drug
  • Elderly
  • Epilepsy
  • Nursing home

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Antiseizure, antidepressant, and antipsychotic medication prescribing in elderly nursing home residents. / Bathena, Sai Praneeth R; Leppik, Ilo E.; Kanner, Andres M; Birnbaum, Angela K.

In: Epilepsy and Behavior, Vol. 69, 01.04.2017, p. 116-120.

Research output: Contribution to journalArticle

Bathena, Sai Praneeth R ; Leppik, Ilo E. ; Kanner, Andres M ; Birnbaum, Angela K. / Antiseizure, antidepressant, and antipsychotic medication prescribing in elderly nursing home residents. In: Epilepsy and Behavior. 2017 ; Vol. 69. pp. 116-120.
@article{47629f8f6e3446fda59391ddf736aeaa,
title = "Antiseizure, antidepressant, and antipsychotic medication prescribing in elderly nursing home residents",
abstract = "Objective The incidence of epilepsy is highest in the elderly and the prevalence of epilepsy is higher in nursing home residents than in other cohorts. Co-medications that act in the central nervous system (CNS) are frequently prescribed in this population. The objective was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of use of antipsychotic and antidepressant medications in elderly nursing home residents receiving ASDs. Methods Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes. Prescribing information was available on ASD, antidepressant, and antipsychotic drugs on one day in October 2013. The frequency distribution by age, formulation, trademarked/generic drugs, route of administration, and multiple drug combinations were determined. Results Overall, 66.8{\%} of 18,752 residents received at least one CNS-active drug as classified by the Generic Product Identifier classification system. For those 65 years and older, ASDs were prescribed for 14.3{\%} residents. Gabapentin comprised 7.3{\%}; valproate 3.0{\%}; levetiracetam 1.8{\%}; and phenytoin 0.9{\%}. An antidepressant was used in 64.2{\%} of persons prescribed an ASD. Antidepressant use varied for specific ASDs and ranged from 50 to 75{\%}. An antipsychotic medication was used in 30{\%} of persons prescribed an ASD and ranged from 16.8 to 54.2{\%} for specific ASDs. Both antidepressant and antipsychotic use occurred in 22.2{\%} of persons prescribed an ASD, respectively. Significance The pattern of CNS-active drug use has changed from previous years in this geographic region. Use of phenytoin has declined markedly, but antidepressant use has increased substantially. The CNS side effect profile of these medications and the possible long-term consequences in this population can greatly complicate their therapy.",
keywords = "Antidepressant, Antipsychotic, Antiseizure drug, Elderly, Epilepsy, Nursing home",
author = "Bathena, {Sai Praneeth R} and Leppik, {Ilo E.} and Kanner, {Andres M} and Birnbaum, {Angela K.}",
year = "2017",
month = "4",
day = "1",
doi = "10.1016/j.yebeh.2017.01.027",
language = "English (US)",
volume = "69",
pages = "116--120",
journal = "Epilepsy and Behavior",
issn = "1525-5050",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Antiseizure, antidepressant, and antipsychotic medication prescribing in elderly nursing home residents

AU - Bathena, Sai Praneeth R

AU - Leppik, Ilo E.

AU - Kanner, Andres M

AU - Birnbaum, Angela K.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objective The incidence of epilepsy is highest in the elderly and the prevalence of epilepsy is higher in nursing home residents than in other cohorts. Co-medications that act in the central nervous system (CNS) are frequently prescribed in this population. The objective was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of use of antipsychotic and antidepressant medications in elderly nursing home residents receiving ASDs. Methods Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes. Prescribing information was available on ASD, antidepressant, and antipsychotic drugs on one day in October 2013. The frequency distribution by age, formulation, trademarked/generic drugs, route of administration, and multiple drug combinations were determined. Results Overall, 66.8% of 18,752 residents received at least one CNS-active drug as classified by the Generic Product Identifier classification system. For those 65 years and older, ASDs were prescribed for 14.3% residents. Gabapentin comprised 7.3%; valproate 3.0%; levetiracetam 1.8%; and phenytoin 0.9%. An antidepressant was used in 64.2% of persons prescribed an ASD. Antidepressant use varied for specific ASDs and ranged from 50 to 75%. An antipsychotic medication was used in 30% of persons prescribed an ASD and ranged from 16.8 to 54.2% for specific ASDs. Both antidepressant and antipsychotic use occurred in 22.2% of persons prescribed an ASD, respectively. Significance The pattern of CNS-active drug use has changed from previous years in this geographic region. Use of phenytoin has declined markedly, but antidepressant use has increased substantially. The CNS side effect profile of these medications and the possible long-term consequences in this population can greatly complicate their therapy.

AB - Objective The incidence of epilepsy is highest in the elderly and the prevalence of epilepsy is higher in nursing home residents than in other cohorts. Co-medications that act in the central nervous system (CNS) are frequently prescribed in this population. The objective was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of use of antipsychotic and antidepressant medications in elderly nursing home residents receiving ASDs. Methods Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes. Prescribing information was available on ASD, antidepressant, and antipsychotic drugs on one day in October 2013. The frequency distribution by age, formulation, trademarked/generic drugs, route of administration, and multiple drug combinations were determined. Results Overall, 66.8% of 18,752 residents received at least one CNS-active drug as classified by the Generic Product Identifier classification system. For those 65 years and older, ASDs were prescribed for 14.3% residents. Gabapentin comprised 7.3%; valproate 3.0%; levetiracetam 1.8%; and phenytoin 0.9%. An antidepressant was used in 64.2% of persons prescribed an ASD. Antidepressant use varied for specific ASDs and ranged from 50 to 75%. An antipsychotic medication was used in 30% of persons prescribed an ASD and ranged from 16.8 to 54.2% for specific ASDs. Both antidepressant and antipsychotic use occurred in 22.2% of persons prescribed an ASD, respectively. Significance The pattern of CNS-active drug use has changed from previous years in this geographic region. Use of phenytoin has declined markedly, but antidepressant use has increased substantially. The CNS side effect profile of these medications and the possible long-term consequences in this population can greatly complicate their therapy.

KW - Antidepressant

KW - Antipsychotic

KW - Antiseizure drug

KW - Elderly

KW - Epilepsy

KW - Nursing home

UR - http://www.scopus.com/inward/record.url?scp=85013661601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013661601&partnerID=8YFLogxK

U2 - 10.1016/j.yebeh.2017.01.027

DO - 10.1016/j.yebeh.2017.01.027

M3 - Article

VL - 69

SP - 116

EP - 120

JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

SN - 1525-5050

ER -