Prevalences and Indications of Psychotropic Drug Prescriptions in Nursing Home Residents with Korsakoff Syndrome

Abstract

Psychotropic drugs (PD) are often prescribed to nursing home residents with Korsakoff syndrome (KS). It is unknown whether these drugs are prescribed correctly or whether they are prescribed off-label, for example, to treat behavioral symptoms. To get more insight into PD prescriptions, a descriptive study was performed. The type, category and indications of PD prescriptions of 285 participants were analyzed using medication charts and questionnaires. Behavioral symptoms were investigated with the Neuropsychiatric Inventory-Questionnaire. The results showed that atypical antipsychotics (57.1%) were prescribed more frequently than typical antipsychotics (49.3%). Of the antidepressants, selective serotonin/norepinephrine reuptake inhibitors (63.1%) were most frequently prescribed, followed by tricyclic antidepressants (23.4%). Of the benzodiazepines, anxiolytics (85.7%) were more prescribed than hypnotics (24.5%). Besides psychiatric disorders, PD were also prescribed to treat behavioral symptoms varying from 29.9% (antipsycho-tics) to 26.3% (benzodiazepines) and 9.3% (antidepressants). Furthermore, prescriptions were high if behavioral symptoms were present. To conclude, PD are often prescribed to residents with KS for an unapproved indication, namely behavioral symptoms. Additional research is needed to obtain further insight into the current prescribing culture and the effectiveness of PD. The insights thus obtained may, ultimately, contribute to the appropriate prescription of PD for people with KS.

Antipsychotic Use and Mortality in Persons with Alcohol-Related Dementia or Wernicke–Korsakoff Syndrome: A Nationwide Register Study in Finland

“…Although our data did not include clinical indications for antipsychotic medication, it is likely that these drugs were often used to treat NPS—a relatively common off-label indication for antipsychotic use. In nursing home patients with alcohol-related neurocognitive disorders, antipsychotics were used both for psychotic disorders (32%), behavioral symptoms (30%), or a combination of both (10%); in particular, irritability and agitation/aggression were associated with antipsychotic prescriptions [ 22 ]. People with WKS or ARD tend to be younger than other dementia patients and physically more active since they are less often impaired in daily activities [ 16 ].…”