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General Practitioners Prescribing Potentially Inappropriate Psychotropic Medications to Older Patients With Generalised Anxiety: Presented at CINP

By Bryan DeBusk, PhD

MUNICH, Germany -- July 18, 2008 -- General practitioners could be prescribing potentially inappropriate psychotropic medications for generalised anxiety disorder (GAD) in as many as 40% of patients aged 65 years and older, according to analysis of a large computerised database with information from encounters with general practitioners in Germany.

Marko Mychaskiw, RPh, PhD, Pfizer Worldwide Medical and Outcomes Research, New York, New York, presented the results in a poster session on July 16 here at the 26th Collegium Internationale Neuro-Psychopharmacologicum (CINP) Congress.

Dr. Mychaskiw noted that long-acting benzodiazepines, hydroxyzine, and some short-acting benzodiazepines and tricyclic antidepressants at high doses have been associated with increased risk for adverse effects in patients aged 65 years and older. And the negative effects of these medications may outweigh their benefits, he said.

To determine whether general practitioners are prescribing these potentially inappropriate medications to older patients, Dr. Mychaskiw and colleagues examined the records of 975 patients aged 65 years or older with a diagnosis of GAD or prescriptions for the disorder. Mean age was 75 years; 72% were female; 29% also had depression.

Of the cohort included in the analysis, 62% had at least 1 prescription for a psychotropic medication and 65% of these patients (40% of all records examined) received prescriptions for 1 or more potentially inappropriate medications.

Long-acting benzodiazepines were prescribed to 23% of patients in the sample (including 9% on diazepam), tricyclic antidepressants were prescribed to 12% of patients (including 7% on doxepin and 5% on amitriptyline), and short-acting benzodiazepines were prescribed at high doses to 10% of patients (including 10% on bromazepam). No differences in prescription rates were noted by age or sex.

Additional research is needed to determine whether general practitioners are prescribing these potentially inappropriate medications only in situations where the benefit clearly outweighs the risks, Dr. Mychaskiw noted.

Funding for this study was provided by Pfizer.


[Presentation title: Potentially Inappropriate Medication Use Among Older Patients With Generalized Anxiety Disorder Under the Care of General Practitioners in Germany. Abstract P09-32]

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