Neuroleptic Prescriptions for Acutely Ill Geriatric Patients

Abstract

This study raises concerns about the quality of documentation around drug use and the adequacy of diagnostic evaluation prior to drug prescription. The strategies of drug treatment do not consistently reflect a working knowledge of the pharmacology of the drug or a diagnosis-based plan of treatment. Future research should focus on physician education and the efficacy of diagnosis and management of the agitated elder.

Longitudinal prescribing patterns of psychotropic drugs in nursing home residents.

“…We believe that this may have occurred earlier in the study, as there had been a greater impetus for adequate documentation in OBRA regulations. A similar lack of documentation of reasons for neuroleptic use in the elderly has been found for patients in acute care hospitals (Hesse, Driscoll, & Jacobson, 1993).…”

Withdrawal of Haloperidol, Thioridazine, and Lorazepam in the Nursing Home

“…Although OBRA regulations have had an effect on psychotropic drug use in nursing homes, significant levels of these drugs continue to be prescribed. 9 Whereas the magnitude of efficacy of psychotropic drugs in treating agitation is under debate, there seems to be an initial effect from the use of neuroleptics and benzodiazepines. 10,11 The question therefore remains, when such drugs are prescribed within currently accepted standards of therapeutics, should drug withdrawal be attempted?…”