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Clinicians occasionally prescribe antipsychotics off label in older adults, usually to manage severe agitation or psychosis in patients with dementia. However, these drugs are associated with significant harms, including increased risks of fracture, stroke, and premature death. To evaluate prescribing trends among adults aged 65 and older in the United States, researchers tapped into a national database of retail pharmacy prescriptions.
Antipsychotic use increased over time, with 4% of older adults receiving a prescription in 2024, compared with 2.7% in 2015. An uptick in prescriptions through long-term care pharmacies accounted for about one third of this difference; presumably this finding largely reflects use for behavio…