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Antipsychotic Reduction in Dementia in VHA Nursing Homes

From 2009 through 2018, off-label use of antipsychotic agents declined among patients with dementia in Veterans Health Administration nursing homes, according to an interrupted time-series design study, but prescribing of other psychotropic and opioid medications increased. “During this period, prescribing of antiepileptics, antidepressants, and opioids increased significantly (antiepileptics: from 26.8% to 43.3%; antidepressants: from 56.8% to 63.4%; opioids: from 32.6% to 41.2%),” the authors report. “Gabapentin served as the main driver of antiepileptic increases (from 11.1% to 23.5%). Increases in antidepressant prescribing included sertraline, mirtazapine, and trazodone. From FY2009 to FY2018, the overall prescribing of non-antipsychotic psychotropic medications grew from 75.0% to 81.1%.”

Source: Aug. issue of American Journal of Psychiatry (2022; 179).