Potential Adverse Outcomes of Psychotropic and Narcotic Drug Use in Canadian Seniors

• Published in: Journal of clinical epidemiology Vol. 50; no. 7; pp. 857 - 863
• Main Authors: Ebly, Erika M, Hogan, David B, Fung, Tak S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-1997; Elsevier
• Subjects: Accidental Falls - statistics & numerical data; Activities of Daily Living; Aged; Biological and medical sciences; Canada; Cognition; cognitive impairment; Dementia; Drug toxicity and drugs side effects treatment; Drug Utilization - statistics & numerical data; Elderly; falls; Humans; Logistic Models; Medical sciences; Miscellaneous (drug allergy, mutagens, teratogens...); narcotics; Narcotics - adverse effects; Narcotics - therapeutic use; Pharmacology. Drug treatments; Polypharmacy; Prevalence; psychotropic drugs; Psychotropic Drugs - adverse effects; Psychotropic Drugs - therapeutic use; self-care ability; Canada; North America; America; narcotics; cognitive impairment; falls; self-care ability; psychotropic drugs; Elderly; Human; Drug; Psychotropic; Toxicity; Cognition; Narcotic analgesic; Epidemiology; Public health
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/S0895-4356(97)00118-2

Potential adverse outcomes (falls, impaired cognition, impaired self-care) of psychotropic (benzodiazepines, antidepressants, antipsychotics) and narcotic medication use were examined in a large sample of Canadians 65 years of age and older. We examined rates of reported falls, Digit Symbol Substitution Test (DSST) scores, and mean number of self-care impairments for those consuming psychotropic and/or narcotic drugs as compared to non-users. Use of psychotropic drugs and/or narcotics was associated with an increased prevalence of falls, lower DSST scores, and/or number of self-care difficulties. For example, in subjects who were cognitively normal, the frequency of falls was 60% greater in benzodiazepine users and 120% greater in users of antidepressants as compared to non-users. Adverse outcomes increased with the number of classes of psychotropic or narcotic medications used. These effects were most pronounced in cognitively normal subjects where the prevalence of falls increased from 13.9% in those consuming none of the medication classes to 42.6% for users of two or more classes. In subjects with mild dementia the use of these medications was not associated with any significant differences in the outcomes measured. Regression models showed that benzodiazepine, antidepressant, and narcotic use remained significant explanatory variables for potential adverse outcomes even after simultaneously considering the effects of several other variables. Although further work is necessary, our results suggest that individuals with better cognitive function may be at particular risk for adverse effects with use of these medications.