Mood-Altering Drugs Top the List continued...
- Elavil (amitriptyline)
- Librium (chlordiazepoxide)
- Valium (diazepam)
- Adapin and Sinequan (doxepin)
- Dalmane (flurazepam)
- Atarax (hydroxyzine)
- Meprobomate (a barbiturate similar to phenobarbital)
- Soma (carisoprodol)
- Parafon Forte (chlorzoxazone)
- Flexeril (cyclobenzaprine)
- Skelaxin (metaxalone)
- Robaxin (methocarbamol)
In this study, Duke researchers reviewed prescription drug claims during 1999 for more than 765,000 people aged 65 and over enrolled in a major medication benefits group. Twenty-one percent filled prescriptions for drugs on the Beers list, and 4% of these patients filled prescriptions for three or more of the drugs.
The two most widely prescribed Beers drugs were the psychotropic drugs Elavil and Adapin, which accounted for just over half of the claims for drugs on the list with potentially severe adverse side effects. These drugs are commonly given at low doses to help elderly people sleep.
The study findings are reported in the Aug. 9/23 issue of the Archives of Internal Medicine.
"Most of the drugs on this list have fallen out of favor for use in general because there are newer and safer alternatives," American Geriatric Society spokesman Todd Semla, PharmD, tells WebMD. "The longer-acting psychotropic drugs are especially risky for older people because the risk of adverse events like hip fractures from falls is so great."
Study Underestimates Problem
In an editorial accompanying the study, geriatric medicine specialist Knight Steel, MD, wrote that the Duke findings probably underestimate the extent of the problem of inappropriate drugs among the elderly "by a wide margin."
Steel concluded that the problem could be addressed through several relatively simple interventions, including prohibiting payment for inappropriate drugs by Medicare and making a computer program available to all pharmacists identifying the drugs in question.
Steel tells WebMD that the use of inappropriate drugs and the overuse of prescription drugs in general are major causes of death and disability among the elderly.
"Just an hour ago I was talking to an 80-year-old who was taking 17 drugs," he says. "Taking 10 or 12 medications is common, and that is too many. We have to change the way we do things so that we get the correct drugs to the right people in the right doses at the right time."