Use of hypnotics in older people with mental illness: a systematic study of tolerability and use in different diagnostic groups

Abstract

Aims The objective of the study was to provide observational clinical data on psychotropic drugs and especially hypnotics used in older people with mental illness. Method This was an observational, single-centre, one-week prevalence study of psychiatric symptoms, disorders and psychotropic/hypnotic drug use in older people with mental illness cared for by the South West Yorkshire Mental Health NHS Trust (Wakefield Locality), UK. Results A total of 593/660 older patients with mental illness (mean±SD age, 76±8.1 years) were assessed). 44.5% had dementia (excluding vascular dementia) and 33.7% had a mood disorder. Of the total, 20.4% did not receive CNS active medication and 46.2% of patients were prescribed an antidepressant. In total 130 (21.9%) of patients were prescribed an hypnotic and these were more likely to be prescribed to patients with depression (35%) compared with other diagnoses (vascular dementia=17.2%, dementia=12.1%, schizophrenia and related disorders=21.5% and anxiety disorders=27.3%) (Χ2=36.3, p<0.001). Zopiclone was the most commonly prescribed hypnotic accounting for 55% of all hypnotic prescriptions and was most commonly prescribed to patients with depression(Χ2=30.4, p<0.001). Conclusions: Hypnotics are commonly used in older people with mental illness including depression, dementia, schizophrenia and anxiety disorders. hey are significantly more likely to be prescribed to patients with depression compared with other diagnostic groups and zopiclone was the most commonly prescribed hypnotic accounting for 55% of hypnotic prescriptions. Hypnotics were generally well tolerated and patients were broadly satisfied with their medication.