Serious safety and cost concerns resulted after a report indicated that older Australians are being over prescribed psychotropic drugs; investigators from the University of Queensland have called for urgent action.

They highlighted, in a report published in the latest edition of the Australian and New Zealand Journal of Psychiatry, “very high levels of psychotropic drug prescribing among older people, particularly older women and those over 80 years of age”.

An immediate review was called for by the team, which involved psychiatrists and public health researchers, because of “substantial doubts” about effectiveness and safety.

Data from Medicare Australia during the 2000s was used to collate findings from separate investigations of three major classes of psychotropics – antipsychotics, antidepressants, and anxiolytic, hypnotic and sedative (AHS) drugs.

Associate Professor Gerard Byrne, UQ’s Head of Psychiatry explained:

“This issue is of growing concern, given the increasing size of the elderly population and the greater vulnerability of older people to adverse effects of drugs and to interactions from multiple drugs that are often being prescribed.”

The high financial cost of the drugs, AUD 702 million in 2007-2008, was also pointed out in the report, which is higher than the Medical Benefits Scheme costs for all mental health services combined.

Byrne said:

“We consider the current level of psychotropic prescribing for older Australians, there is a pressing need to know more about the epidemiology, sociology and optimal use of medicines that in many cases may be unnecessary, costly or potentially harmful.”

Antipsychotics (such as olanzapine and risperidone) – more questions are being raised surrounding the risks and benefits of use in older people. Although at low doses, in some age care facilities there has been an increase in use.

Antidepressants (such as SSRIs and venlafaxine) – despite depressive symptoms being common among those with dementia and those in residential aged care facilities, the effectiveness of antidepressants in these groups is not proven.

Anxiolytics, hypnotics and sedatives (such as benzodiazepine and temazepam) – usage is inconsistent with recommendations for short-term use and the evidence that there are lower rates of anxiety disorders in older age groups. AHS use in older people is linked with cognitive impairment, delirium and an increased risk of falls and accidents.

Written by Grace Rattue