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Psychosis scripts double for older people

Date

Amy Corderoy

Prescriptions by age in 2011.

Prescriptions by age in 2011.

OLDER Australians are being prescribed antipsychotic drugs at an "astonishing" rate which experts say indicates a potentially deadly overprescription for behaviour control in dementia patients.

Antipsychotic drugs are given to people aged over 67 at twice the rate they are given to younger people, according to Medicare data obtained under freedom of information.

Last year more than 1 million prescriptions for antipsychotic medications - and 4 million for antidepressants - were written for people aged over 67.

The rates have been increasing steadily despite academics and doctors warning of dangerous side effects from the inappropriate use of medications.

A clinical professor at the medical school at Sydney University, John Snowdon, said antipsychotic medication had been shown to double the risk of death in dementia patients, as well as increasing illness.

It was extraordinary that doctors would prescribe such medications so freely, often for symptoms such as agitation, despite their having little efficacy. "It is astonishing there should be such a difference between the elderly and the middle aged," he said.

An analysis of prescribing numbers provided by the Department of Human Services shows there were nearly 40 antipsychotic prescriptions for every 100 older Australians compared with 20 for every 100 people aged 62 to 66.

And the rate of antidepressant prescriptions averages more than one each year for every person aged over 67.

Matthew Large, a psychiatrist and researcher at the University of NSW who analysed the data for the Herald, said he was shocked. "It's very unlikely the need for prescriptions of antidepressants suddenly jumps when you are 67," he said.

It was difficult to know how many people were taking the drugs, as numbers of prescriptions varied per person. But the figures could indicate about 10 per cent of over 67s were taking antidepressants.

A clinical adviser for the National Prescribing Service, Philippa Binns, said depression among older people was growing. "Even though the prescription rates are high there could actually also be under-diagnosis. But … in the older age group the effect of antidepressants is modest at best … we should always be thinking about non-medical options.''

David Lie, a staff specialist at the Centre for Trauma, Loss and Disaster Recovery, at Metro South Mental Health in Queensland, said: "Some of these drugs are among the high-cost items and their risk profile means that their side effects can actually increase health costs in terms of things like falls.''

Samantha Hollingworth, a senior lecturer in pharmacy at the Pharmacy Australia Centre of Excellence at the University of Queensland, said it was encouraging that prescriptions for both types of drugs had fallen last year - 170 antipsychotic prescriptions per 100 people in 2010 compared with 164 last year.

acorderoy@smh.com.au

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