POTENTIAL ADVERSE OUTCOMES OF PSYCHOTROPIC AND NARCOTIC DRUG-USE IN CANADIAN SENIORS

Potential adverse outcomes (falls, impaired cognition, impaired self-c are) of psychotropic (benzodiazepines, antidepressants, antipsychotics ) and narcotic medication use were examined in a large sample of Canad ians 65 years of age and older. We examined rates of reported fails, D igit Symbol Substitution Test (DSST) scores, and mean number of self-c are impairments for those consuming psychotropic and/or narcotic drugs as compared to non users. Use of psychotropic drugs and/or narcotics was associated with an increased prevalence of falls, lower DSST score s, and/or number of self-care difficulties. For example, in subjects w ho were cognitively normal, the frequency of falls was 60% greater in benzodiazepine users and 120% greater in users of antidepressants as c ompared to non-users. Adverse outcomes increased with the number of cl asses of psychotropic or narcotic medications used. These effects were most pronounced in cognitively normal subjects where the prevalence o f falls increased from 13.9% in those consuming none of the medication classes to 42.6% for users of two or more classes. In subjects with m ild dementia the use of these medications was not associated with any significant differences in the outcomes measured. Regression models sh owed that benzodiazepine, antidepressant, and narcotic use remained si gnificant explanatory variables for potential adverse outcomes even af ter simultaneously considering the effects of several other variables. Although further work is necessary, our results suggest that individu als with better cognitive function may be at particular risk for adver se effects with use of these medications. (C) 1997 Elsevier Science In c.