Need for Higher Regulation of Off-Label Antipsychotic Prescribing in the Elderly
Location
CSU 201
Start Date
16-4-2013 11:10 AM
End Date
16-4-2013 12:10 PM
Student's Major
Psychology
Student's College
Social and Behavioral Sciences
Mentor's Name
Dawn Albertson
Mentor's Department
Psychology
Mentor's College
Social and Behavioral Sciences
Description
This review focused on the appropriateness of off-label use of second generation antipsychotics (SGA) as the treatment in the elderly for psychological and behavioral symptoms of dementia (BPSD) such as agitation. Currently, Beers Criteria by the American Geriatrics Society is the only reference for determining whether a prescription medication is a potentially inappropriate medication (PIM) for use in older adults. After reviewing Beers Criteria, the results indicated a specific need for further research into antipsychotics as PIMs. One major need identified was to differentiate between first-generation (FGA) and second-generation antipsychotics based on the large difference in their pharmacokinetic (PK) and pharmacodynamics (PD) properties. The articles reviewed focused on SGAs only; specifically olanzapine, risperidone, and aripiprazole. These drugs were selected because they have been observed to have small but statistically significant benefits in the off-label treatment of behavioral symptoms associated with dementia in elderly patients. Other articles reviewed, further identified areas that support the need for higher regulation of the prescribing rates beyond Beers Criteria. Specific areas of interest were articles on studies indicating an altered PK/PD model due to the decrease in drug metabolism, increased likelihood of polypharmacy, and increased comorbidity of diseases associated with age. The discussion emphasized the importance of these results and how they could be better indicated in Beers Criteria along with areas that need further exploration.
Need for Higher Regulation of Off-Label Antipsychotic Prescribing in the Elderly
CSU 201
This review focused on the appropriateness of off-label use of second generation antipsychotics (SGA) as the treatment in the elderly for psychological and behavioral symptoms of dementia (BPSD) such as agitation. Currently, Beers Criteria by the American Geriatrics Society is the only reference for determining whether a prescription medication is a potentially inappropriate medication (PIM) for use in older adults. After reviewing Beers Criteria, the results indicated a specific need for further research into antipsychotics as PIMs. One major need identified was to differentiate between first-generation (FGA) and second-generation antipsychotics based on the large difference in their pharmacokinetic (PK) and pharmacodynamics (PD) properties. The articles reviewed focused on SGAs only; specifically olanzapine, risperidone, and aripiprazole. These drugs were selected because they have been observed to have small but statistically significant benefits in the off-label treatment of behavioral symptoms associated with dementia in elderly patients. Other articles reviewed, further identified areas that support the need for higher regulation of the prescribing rates beyond Beers Criteria. Specific areas of interest were articles on studies indicating an altered PK/PD model due to the decrease in drug metabolism, increased likelihood of polypharmacy, and increased comorbidity of diseases associated with age. The discussion emphasized the importance of these results and how they could be better indicated in Beers Criteria along with areas that need further exploration.
Recommended Citation
Cardetti, Caitlyn. "Need for Higher Regulation of Off-Label Antipsychotic Prescribing in the Elderly." Undergraduate Research Symposium, Mankato, MN, April 16, 2013.
https://cornerstone.lib.mnsu.edu/urs/2013/oral-session-06/4
