title: Psychotropic medication in geriatric psychiatric patients: use and unreported use in relation to serum concentrations.
abstract: OBJECTIVE
  The aim of this observational study was to describe the type, number, and serum concentration levels of psychotropic drugs in elderly patients, on admission to a geriatric psychiatric inpatient unit. We further wanted to investigate the use and unreported use of psychotropic drugs by analyzing for a broad spectrum of drugs in the serum samples.
  
  
  METHODS
  A total of 236 patients were included. Drug use, patient characteristics, and diagnoses were recorded, and serum analysis was performed for a total of 56 psychotropic drugs in 233 of the patients.
  
  
  RESULTS
  Nine out of ten patients (88%) used one or more psychotropic drugs on admission to hospital; the mean use was 2.8 (95% confidence interval (CI) 2.6-2.9) drugs. In 25 patients (11%), drugs reported used were not detected in serum. Unreported use of drugs (serum analysis revealing one or more drugs not reported) was found in 100 patients (43%). This was more common in younger patients. Psychotropic polypharmacy (use of three or more psychotropic drugs) was found in 109 patients (47%). Patients with a main diagnosis of affective disorder used the most psychotropic drugs.
  
  
  CONCLUSIONS
  Psychotropic drugs are commonly used among geriatric psychiatric patients on admission to hospital. Psychotropic polypharmacy is a major concern among these patients. There was considerable unreported use of drugs within this population, and a low threshold for a broader serum analysis for psychotropic drugs appears indicated.
authors.affiliation: Department of Geriatric Psychiatry, Diakonhjemmet Hospital, PO Box 85, Vinderen, 0319, Oslo, Norway, marit.tveito@me.com.
authors.forename: Marit
authors.initials: M
authors.lastname: Tveito
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.forename: Bernhard
authors.initials: B
authors.lastname: Lorentzen
authors.forename: Helge
authors.initials: H
authors.lastname: Refsum
authors.forename: Gudrun
authors.initials: G
authors.lastname: Høiseth
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000097:blood / Q000627:therapeutic use; D001569:Benzodiazepines / Q000097:blood / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000188:drug therapy; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000097:blood* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D011619:Psychotropic Drugs; D001569:Benzodiazepines