Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Antipsychotic Use Examined Across Wide Age Range

Int J Geriatr Psych; ePub 2018 Jul 8; Jester, et al

Antipsychotic (AP) use varied by age, with stronger associations between on‐label conditions and AP use among younger adults and off‐label conditions among older adults, according to a recent study that assessed factors related to AP use in skilled nursing facilities for newly-admitted residents. Several less conventional determinants, namely, Parkinson disease, traumatic brain injury, and the use of physical restraints, were identified to increase the likelihood of AP use. >1 million US residents (aged 18 to ≥85 years) were included in a retrospective, population‐level, data set. Antipsychotic use was defined as APs dispensed daily for the prior 7 days. Researchers found:

  • Bipolar disorder and schizophrenia were consistently related to AP use across age groups.
  • For older age groups, off‐label indications such as cognitive impairment, dementia, behavioral symptoms, and physical restraint use were more closely related to AP use, while delusions and hallucinations decreased in strength.
  • Higher proportions of APs were found in all diseases and symptoms in nonelderly adults, with the exception of physical restraint use.
  • Concurrent physical restraint and AP use was highest for older adults (aged 65 to 84 years) at 36%.

Jester DJ, Hyer K, Molinari V, Andel R, Rozek E. Age‐dependent determinants of antipsychotic use among newly admitted residents of skilled nursing facilities: A population‐based study. [Published online ahead of print July 8, 2018]. Int J Geriatr Psych. doi:10.1002/gps.4934.

This Week's Must Reads

Early-Life Stress Linked with Cytomegalovirus in MDD , JAMA Psychiatry; ePub 2019 Mar 6; Ford, et al

Collaborative Intervention for Obesity, Depression , JAMA; 2019 Mar 5; Ma, Goldman Rosas, Lv, et al

Body Weight Predicts Risk for Depressive Symptoms , J Affect Disord; ePub 2019 Mar 5; Vittengl

Slow-Wave Activity and Mood Disturbance in MDD, Psychol Med; 2019 Mar; Goldschmied, et al

Marijuana Use in MDD May Be Contraindicated, Cogn Affect Behav Neurosci; ePub 2019 Feb 26; Radoman, et al

Must Reads in Geriatrics

Disparities in Receipt of ECT in Depressed Elderly, Am J Geriatr Psychiatry; ePub 2018 Nov 29; Jones, et al

Depression in Later Life Intervention is Effective, JAMA Psychiatry; ePub 2018 Nov 7; Dias, et al

More than One-Third of Older Adults Use Sleep Aids, Am J Geriatr Psychiatry; ePub 2018 Sep 14; Maust, et al

Older Adults and Worry: Which Treatments Work Best?, Am J Geriatr Psych; ePub 2018 Aug 7; Stanley, et al

Gender Differences in Schizophrenia May Vary by Age, Am J Geriatr Psychiatry; ePub 2018 Jul 27; Muralidharan, et al