title: Psychotropic Polypharmacy in Patients with Dementia: Prevalence and Predictors.
abstract: Antipsychotics and other psychotropics are frequently used to treat neuropsychiatric symptoms in patients with dementia, even though the evidence for effect is limited. Concerns have been raised about the safety of antipsychotics, but concomitant use of multiple psychotropic drug classes (psychotropic polypharmacy) may also pose a risk for patients.
  
  
  
  To investigate the prevalence and predictors associated with use of psychotropic polypharmacy in patients with dementia.
  
  
  
  A population-based study using nationwide registers. Patients with dementia were identified among all Danish residents ≥65 years on January 1, 2012. Data on prescriptions and comorbidity was included in the analysis. Overlapping prescriptions for different psychotropic drug classes were used to determine psychotropic polypharmacy. A multivariable logistic regression analysis was conducted to evaluate factors independently associated with the prescription of other psychotropic drug classes among patients already using antipsychotics.
  
  
  
  Among all patients registered with dementia (34,553), 25.3% (8,728) used ≥2 psychotropic drugs. Among patients treated with antipsychotics 75.8% (5,403) used at least one other psychotropic drug during the antipsychotic treatment period. Nursing home residency, number of non-psychotropic medications used in 2011, and prior psychiatric diagnosis were associated with psychotropic polypharmacy among antipsychotic drug users. The most frequent combination of psychotropic drugs was antipsychotics and antidepressants.
  
  
  
  Concomitant use of psychotropic drugs was frequent in dementia patients. Patients living in nursing homes had the highest risk of receiving a combination of antipsychotics and other psychotropic drugs. Concomitant use of psychotropics may cause adverse events, and potential consequences for patients' safety call for further investigation.
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ane
authors.initials: A
authors.lastname: Nørgaard
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Jensen-Dahm
authors.affiliation: National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
authors.forename: Christiane
authors.initials: C
authors.lastname: Gasse
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Elsebet Steno
authors.initials: ES
authors.lastname: Hansen
authors.affiliation: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology*; D003718:Denmark; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D016017:Odds Ratio; D019338:Polypharmacy; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012042:Registries; D012307:Risk Factors
chemical_list: D011619:Psychotropic Drugs
keywords: Antidepressant drugs; antipsychotic drugs; dementia; pharmacoepidemiology; polypharmacy; psychotropic drugs