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Predictors of CNS-Active Medication Use and Polypharmacy Among Homebound Older Adults With Depression.

Choi NG, Marti CN, Kunik ME. Predictors of CNS-Active Medication Use and Polypharmacy Among Homebound Older Adults With Depression. Psychiatric services (Washington, D.C.). 2020 Aug 1; 71(8):847-850.

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Abstract:

OBJECTIVE: The authors assessed central nervous system (CNS) polypharmacy among low-income, racially diverse homebound older adults with depression (N = 277) and its associations with the participants'' ratings of depressive symptoms and pain. METHODS: CNS-active and other psychotropic and analgesic medications intake was collected from patients'' medication containers. Depressive symptoms were assessed with the 24-item Hamilton Depression Rating Scale, and pain intensity was measured on an 11-point numerical rating scale. Covariates were disability (World Health Organization Disability Assessment Schedule 2.0) and perceived social support (Multidimensional Scale of Perceived Social Support). RESULTS: Of the patients, 16% engaged in CNS polypharmacy, taking three or more CNS-active medications. Of these, 69%, 69%, and 89% were using selective serotonin reuptake inhibitors, benzodiazepines, and opioids, respectively. Higher pain intensity ratings were associated with CNS polypharmacy. Benzodiazepine users were more likely than nonusers to use opioids. CONCLUSIONS: Medication reviews and improved access to evidence-based psychotherapeutic treatments are needed for these older individuals with depression.




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