Psychotropic drug

About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.

Mental disorders in ulcerative colitis: suicide, divorce, psychosis, hospitalization for mental disease, alcoholism, and consumption of psychotropic drugs in 178 patients subjected to colectomy.

Abstract: The population in the Nordic countries is relatively homogenous. In 178 Norwegian patients subjected to colectomy for ulcerative colitis the frequencies of suicide, divorce, psychosis, and hospitalization for mental disorders, and consumption of psychotropic drugs, did not differ significantly from corresponding frequencies in the general population.

Association between changes in the use of psychotropic drugs and behavioural and psychological symptoms of dementia over 1 year among long-term care facility residents.

Abstract: Aim Pharmacological treatments are often used in treating the behavioural and psychological symptoms of dementia (BPSD) in nursing homes, despite the fact that non-pharmacological treatments are recommended as a first-line treatment and can provide a suitable alternative. Because the course of BPSD is known to fluctuate depending on individual symptoms over time, the frequencies of drug use and BPSD, as well as their association, should be observed over a longer period. We investigated the association between the changes in psychotropic drug (PD) use and BPSD, focusing on the number of symptoms, severity, and care burden over 1 year among long-term care facility residents. Methods A 1-year follow-up study was conducted among older residents with dementia or similar symptoms (n = 312 at baseline; n = 237 at follow-up) by using a care staff questionnaire in 10 long-term care facilities in Hokkaido, Japan. Medication use was determined based on prescription information. The brief questionnaire form of the Neuropsychiatric Inventory was used to assess BPSD. Results Among residents followed up for 1 year, new users of PD-particularly anxiolytics and hypnotics-had a significantly increased number and severity of BPSD, compared with non-PD users. Continuing PDs was also related to increased severity over the year. Among residents with any persistent BPSD for 1 year, new use of PDs-particularly anxiolytics and hypnotics-was significantly associated with an increased care burden of BPSD, compared with the non-use of PDs. The discontinuation of PDs was significantly associated with a decreased care burden, compared with the non-use of PDs. Conclusions Our study suggests that PDs, particularly anxiolytics and hypnotics, may be prescribed carefully in response to exacerbation of BPSD in terms of the number of symptoms, severity, and care burden in long-term care facilities. Continuous monitoring of PDs use and BPSD is important to effectively address BPSD.

Sleep Alterations in Non-demented Older Individuals: The Role of Cortisol.

Abstract: Background: Sleep alterations can impair quality of life and contribute to disease progression but they, and their features and contributing factors, are rarely analysed in institutionalised older individuals. In this study, we investigated sleep alterations, the factors involved, and the role of cortisol in sleep-related problems in institutionalised individuals. Methods: We conducted a descriptive cross-sectional study in participants living in nursing homes in Valencia (Spain); sleep alterations were determined based on two validated tools: the Athens insomnia scale and Oviedo sleep questionnaire. Plasma cortisol was measured in the morning and determined by high performance liquid chromatography-mass spectroscopy, along with other blood analytical parameters. We also analysed any confounding factors (sleep duration, morning awakening time, intake of hypnotic and psychotropic medication, and cognitive function). Results: The mean age was 82.5 years (range: 65-99); approximately 80% were women and sleep alterations were present in 25-60% of the population, depending on the scale used or type of sleep disorder considered. There was no significant correlation between morning cortisol concentrations and sleep disorders, sex, age, or psychotropic drug ingestion (including hypnotic drugs). However, there was a significant correlation between cortisol and an Oviedo questionnaire subscale for evaluating insomniarelated adverse events, which remained significant after adjusting for multiple potentially confounding factors. Conclusion: Sleep disorders are common in institutionalised older individuals and are not related to sleep duration or decreased by ingestion of hypnotic medications. There is a significant relationship between morning cortisol levels in blood and insomnia-related sleep disorders (e.g. snoring with awakenings, nightmares, restless legs syndrome, etc.) but not directly with insomnia or hypersomnia.

Dispensing of psychotropic drugs to adults in community pharmacies in Latvia.

Abstract: Objective To estimate outpatient utilization of psychotropic drugs before and after pharmaceutical reform in Latvia. Setting Data concerning prescribing and dispensing of psychotropic drugs were collected in six community pharmacies in the region of Latgale of Latvia. Method An exploratory analysis of prescription data provided by six community pharmacies from 2004 to 2007. Drugs included in the study were classified according to an Anatomical–Therapeutic–Chemical (ATC) drug classification system, and ATC data were used to calculate defined daily doses (DDD) per 1,000 inhabitants. The National SSK-10 classification was used for analysis of codes of disease diagnosis. Main outcome measures Identification of the most often prescribed psychotropic drug and prescribing physician, patient characterization by age and gender, and analysis of codes of diseases. Results Benzodiazepines and benzodiazepine-related drugs were mainly prescribed in outpatient practice. Diazepam was the most frequently prescribed benzodiazepine-12 DDD/1,000/day. The drugs were prescribed mainly by family physicians (in 66% of cases). Female residents bought more psychotropic drugs than males. In addition, residents of cities bought little more drugs than those living outside urban areas. Accordingly to the recorded disease codes, the codes for neurotic and behavioral disorders dominated. Conclusion The introduction of new norms neither increased nor decreased the number of psychotropic drug prescriptions filled. The most often prescribed psychotropic drugs over 4-year period were benzodiazepines and their derivates. Disease codes on the prescriptions fully justified a reason for psychotropic drug use.

Clinical Problems in Treating the Aged With Psychotropic Drugs

Abstract: The purpose of this paper is to review the use of psychotropic drugs in the aged. Psychotropic agents can be an effective tool in a physician’s armamentarium in treating mental disorders in the aged. However, these drugs can also be inappropriately used. The aged may be more susceptible to certain drug side effects. In addition, since they are more apt to have medical problems, there is more likelihood of drug-drug interactions occurring. Even physicians who may not be particularly interested in psychotropic drug use may need to be knowledgeable about this aspect of patient care since patients may suffer from toxicity due to psychotropic drugs administered by another physician or by the patients themselves. Psychotropic drugs are commonly taken by a large percentage of the population of the United States (Balter and Levine, 1971). Two hundred twenty million prescriptions are filled by patients for psychotropic drugs; 80 million for antianxiety agents; 40 million for hypnotics; 30 million for stimulants. Patients can often be taking several psychotropic drugs, sometimes administered by one physician, sometimes administered by several different physicians with the patient continuing to take one doctor’s prescription as well as a second psychotropic agent added by another doctor. To this cocktail can be added proprietary medications bought without prescription. Since sedative hypnotics do reduce mental function, it is not unusual to find elderly patients who are over-medicated who may do better when they discontinue the cocktail of sedative hypnotic drugs which they are taking. For that reason, the first problem in treating the aged with psychotropic drugs is for the clinician to consider whether the patient needs the psychotropic drugs he may be on. The discontinuance of current medication to get a drug-free baseline state is a useful strategy for the treatment of many patients. It is important to evaluate the patient’s medical status and use of the wide variety of drugs for treating his medical problems. This information is relevant to drug-drug interactions and side effects of possible psychotropic drugs. Having reviewed the patient’s baseline status and his medical problems, one may move on to consider which psychotropic drugs may be indicated for a given patient.