3 in 4 Elders with Dementia Fill Prescriptions for Psychotropics or Opioids

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Elders with dementia commonly fill prescriptions for medications that act on the central nervous system (CNS) — despite substantial risks and little evidence of benefit — a JAMA study finds.

Of nearly 740,000 Medicare beneficiaries with diagnoses of dementia, roughly three quarters filled at least one prescription for a CNS-active medication between 2014 and 2015. Antidepressant fills were most common (50% of the cohort), followed by opioids (30%) anxiolytics/sedatives-hypnotics (27%), antiepileptics (22%), and antipsychotics (22%). Prescription fills were generally more common among women, those aged 65–74, white adults, and lower-income adults.

Two opioids were the most common individual medications filled: hydrocodone (14%) and tramadol (12%). Quetiapine, sertraline, and gabapentin were also frequently filled.

The researchers note, "None of these medications are approved in the US to treat dementia or its behavioral symptoms; all are associated with adverse events among older adults, including falls, sedation, and increased risk of death."