TOPLINE:

The use of antipsychotics among US adults aged 65 years or older increased by 52% from 2015 to 2024, a new study showed. Although antipsychotic prescriptions from psychiatrists decreased during the time period, those from long-term care pharmacies increased significantly.

METHODOLOGY:

• Researchers conducted a cross-sectional study using IQVIA Longitudinal Prescription Claims data from 2015 to 2024, covering more than 90% of all retail pharmacy prescriptions.
• They analyzed data for more than 8 million adults aged 65 years or older (59% women) who received at least one antipsychotic prescription. Patients were stratified by age into three groups: 65-69 years, 70-74 years, and ≥ 75 years.
• The primary analysis included rates and trends of annual use of antipsychotics from 2015 to 2024.
• Additional analyses included rates of long-term use of antipsychotics, defined as 120 or more days, and the percentage of patients with at least one antipsychotic prescription from a psychiatrist or long-term care pharmacy and for first-generation antipsychotics.

TAKEAWAY:

• The use of antipsychotics per 100 persons significantly increased from 2.67 in 2015 to 4.05 in 2024 among the full group, with the highest increase (61%) in those aged 65-69 years (P < .001); the use increased from 2.97 to 4.57 for women and from 2.25 to 3.42 for men during the same timepoints (P < .001 for both).
• Long-term use of antipsychotics per 100 older persons increased from 1.49 in 2015 to 2.45 in 2024 (P < .001).
• The percentage of patients with antipsychotic prescriptions from psychiatrists declined significantly from 30% to 20% (P < .001), whereas the percentage of those with antipsychotic prescriptions from a long-term care pharmacy increased from 14% to 21% (P = .006).
• The use of first-generation antipsychotics decreased from 22% in 2015 to 14% in 2024 (P < .001), suggesting a transition to newer medications.

IN PRACTICE:

“An increase in antipsychotic treatment of older US adults should prompt renewed efforts to improve mental health and behavioral interventions in this age group. This includes evaluation and dissemination of promising nonpharmacological interventions,” the investigators wrote.

SOURCE:

This study was led by Mark Olfson, MD, MPH, New York State Psychiatric Institute, New York City. It was published online on December 03 in JAMA Psychiatry.

LIMITATIONS:

This study was limited by the use of filled antipsychotic prescriptions as a proxy for actual use, the absence of clinical diagnoses, top coding of age that prevented analysis of older age groups, and the lack of a denominator for residents served by long-term care pharmacies.

DISCLOSURES:

Several investigators reported receiving grants from multiple sources, which are fully listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.