The number of seniors in America taking three or more drugs that act
on their brain has increased over the last ten years,
- More elderly
people in the United States are being prescribed three or more drugs
acting on the brain.
- Such prescribing
patterns could increase the risk of falls and fractures in this group.
methods like psychotherapy should be offered to patients instead of
medications whenever possible.
was a study that had been recently publlished inJAMA Internal Medicine
There are several types
of drugs that affect the brain.
- With the ever
increasing rise of depression in the modern age, the prescription of
antidepressants is on the rise.
drugs are used to treat psychosis - which can be considered the opposite
- Tranquilizers are
used to calm agitated patients or to enhance sleep at night.
- Though mild pain
is treated with acetaminophen and non-steroidal drugs like ibuprofen and
diclofenac, severe pain that may be caused by diseases of older age like
arthritis and cancer are treated with opioids, which again act on the brain.
The researcher team
from the University of Michigan and VA Ann Arbor Healthcare System found that
the number of older patients who receive three or more of these medications is
on the rise. The team analyzed data collected by the Centers for Disease Control and
Prevention (CDC) from doctors' offices between the years 2004 and 2013.
‘Over prescription of drugs acting on the brain in seniors can be dangerous!’
In their study, the
team found that:
- The number of
doctor visits by people over the age of 65 years taking three or more
medications that act on the brain doubled from 0.6% in 2004 to 1.4% in
- In fact in rural
areas, rate of doctor visits by seniors taking combinations of drugs that
act on the brain more than tripled
- Nearly half the
patients taking multiple brain medications are not formally diagnosed as
suffering from the condition like a mental health problem, insomnia or pain for which they need the
medication. Ideally, patients should meet the underlined criteria for the
condition before the medication is prescribed
One of the reasons for
the need for multiple medications could be that there is more awareness about
mental conditions like depression that can be treated. However, taking multiple
medications that act on the brain can have serious consequences especially in
- The liver which
metabolizes these drugs may not be functioning to its maximal capacity in
old age, due to which the drug levels may be higher than in younger
adults. The kidney function may also be reduced, as a consequence of which
the levels of drugs that are excreted unchanged in the urine will rise in
- In addition, the
multiple drugs could interfere with the metabolism of each other, thus
increasing their blood levels
- The drugs will have an additive effect on the brain
that could affect memory and thinking and cause decline in cognitive
functions. The brain of older individuals may also be extra sensitive to
- The additional drowsiness caused by the combinations
could interfere with driving and increase dependence on others. It could
also increase the chances of falls and subsequent fractures
- The US FDA has
warned against the use of an opioid with a benzodiazepine
due to an increased risk of death
However, it does not
mean that treatment should be denied for the patient if he/she needs it. It is
first necessary to reach a correct diagnosis. Many of the conditions can be
treated with non-pharmacological treatments like psychotherapy
should be offered to the patient, and medications should be prescribed only
when definitely needed.
- JAMA Internal Medicine, DOI:10.1001/jamainternmed.2016.9225