Conventional psychotropic medications used in managing the behavioral health of nursing home residents may actually carry increased risks compared to atypical antipsychotics, according to researchers from Brigham and Women’s Hospital in Boston.
In a study recently published in the Canadian Medical Association Journal, the researchers evaluated the comparative safety of various psychotropic medication classes on nursing home residents because of the extensive use of these drugs in this setting and the complexity of resident illnesses. The study cohort included all British Columbia residents admitted to a nursing home between Jan. 1, 1996-March 31, 2006, and who received a psychotropic drug within 90 days of admission.
Of the 10,900 patients in the study, 1,942 received an atypical antipsychotic, 1,902 a conventional antipsychotic, 2,169 an antidepressant, and 4,887 a benzodiazepine. “Rigorous methodological approaches were applied to ensure this non-randomized study was not affected by the selective prescribing that tends to occur in routine care,” according to a release.
"In 10,900 older adults newly admitted to nursing homes in BC who began taking psychotropic medications, we observed risks of death that were higher among those who initiated conventional antipsychotics, antidepressants, and benzodiazepines,” researchers wrote. “We also observed risks of femur fracture that were higher with conventional antipsychotics, antidepressants, and benzodiazepines used for anxiety, all compared with atypical antipsychotics.”
Researchers concluded that a large randomized trial is required to confirm their findings, but that clinicians should still weigh these increased risks when prescribing such medications for nursing home residents.