PSYCHOTROPIC-DRUG NSE IN A GROUP OF DUTCH NURSING-HOME PATIENTS WITH DEMENTIA - MANY USERS, LONG-TERM USE, BUT LOW-DOSES

The aim of this study was to describe the use of psychotropic drugs in a psychogeriatric nursing home, ''Joachim en Anna'', in Nijmegen, the Netherlands. To this end the medical records of 890 nursing home pati ents with dementia, admitted between 1980 and 1989, were analysed retr ospectively. Each time pattern of psychotropic drug use was registered . Drugs were coded by means of the Anatomical Therapeutic Chemical cla ssification system. The daily dose was expressed as the ratio of the m ean prescribed daily dose and the defined daily dose. Side-effects and changes in prescription patterns throughout the years patients were a dmitted were analysed. A total of 3,090 time patterns of exposure to p sychotropics were registered. Neuroleptics, benzodiazepines, and antid epressants accounted for 58, 32, and 9% of the time patterns, respecti vely. For almost every drug prescription the prescribed daily dose was lower than the defined daily dose. More than 75% of these nursing hom e patients had at least one prescription for a psychotropic drug durin g institutionalization. One or more side-effects were observed in 50% of the patients who used a neuroleptic. The total number of patients r eceiving psychotropics did not change throughout the study. Psychotrop ics were prescribed for long-term use, but in a low dose. Side-effects were frequently observed while the correct individual dose was being determined.