2023-04-21 08:31:12
France has long been a country that consumes a lot of psychotropic drugs, anxiolytics, antidepressants, antipsychotics, etc. What is the situation among the elderly? A recent French review takes stock of the use of these drugs until the start of the Covid-19 epidemic. Data that has just been published in the scientific journal Therapies.
What is the consumption of psychotropic drugs among the elderly in France?
THE psychotropic drugs constitute one of the most prescribed pharmacological classes in France. They include all drugs that act on the neurobiological mechanisms of the brain, namely:
- THE anxiolyticslike the benzodiazepinesused once morest anxiety disorders;
- THE hypnoticsalso called the sleeping tabletswho fight once morest sleep disorders;
- THE antidepressantsshown in depression;
- THE mood regulators or normothymicfor example prescribed once morest bipolar disorders;
- THE neurolepticsalso called the antipsychoticsused in particular in schizophrenia.
The most prescribed psychotropic drugs in the elderly are anxiolytics, hypnotics and antidepressants. Their prescription and use are the subject of recommendations, taking into account the particular risks in the elderly, including the risk of drug interactions (elderly person taking multiple medications) and the risk of falling (risk factor for dependence).
A drop in the consumption of psychotropic drugs, but the situation remains worrying for the elderly
In 1994, a first report on the use of psychotropic drugs revealed that the elderly had significant recourse to these drugs, in particular to anxiolytics. The prescriptions of anxiolytics were then multiplied by ten compared to those of the United Kingdom. In this new review, the data taken into account provide an overview of the situation between 2006 and 2019, that is to say before the start of the Covid-19 pandemic. The general trend shows a decrease regarding 10% of the consumption of psychotropic drugs by French seniors. The decrease is even greater for anxiolytics, with a 30.6% reduction in the prevalence of consumption.
Despite this apparent good news, the consumption of psychotropic drugs by the elderly remains worrying, and higher than that observed in other European countries. Thus, 41% of women and 28% of men over the age of 65 used at least one psychotropic drug during 2013. While the use of antidepressants remains high (13% of subjects aged 65 to 74 years and 18% of subjects aged over 75 consumed them in 2013), consumption has evolved with increasing use of second-generation drugs. Second-generation drugs generally have fewer side effects than first-generation drugs.
A resumption of the consumption of psychotropic drugs with the Covid-19 epidemic!
Another striking fact revealed by this study, the use of psychotropic drugs is inappropriate in a large number of cases, greater than 30%, for example for benzodiazepines. Inappropriate uses cover in particular excessively long periods of use, the combination of several psychotropic drugs or the prescription of psychotropic drugs outside the therapeutic indications of the drugs. All of these settings are associated with significant risks for older people.
In recent years, public health authorities have multiplied information and prevention messages, while increasingly regulating the prescription of psychotropic drugs. But to date, these measures have proven insufficient to significantly reduce the use of psychotropic drugs in the elderly. And the phenomenon does not seem to be improving, because the latest data collected by Health Insurance since the start of the Covid-19 epidemic seem to indicate a stabilization or even an increase in the consumption of psychotropic drugs among seniors!
Estelle B., Doctor of Pharmacy
Sources
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