Polypharmacy in the treatment of elderly patients

Objective What results has the use of polypharmacy to the course and outcome of elderly patients? Methods The number of patients older than 65 years with dementia, depression and schizophrenia based on BADO information system for the years 2002 to 2004 were evaluated. Then the recommended long-term medical treatment for these inpatients were documented and the differences in psychtropic mono- and polypharmacy with their side effects were reflected. Results The percentage of elderly patients treated with polypharmacy reduced from 78% to 69%. More than 1/3 of the patients had any relevant side effects. Especially internistic complications like edema, hyponatremia and orthostatic dysregulation are the most common side-effects from psychotropic drugs in elderly patients. Conclusions The reasons to use psychotropic polypharmacy are the same like younger patients. In contrast the interaction with other medications increases with age, morbidity, sum of medication and the number of involved doctors. Thus it is in this population group especially important to prefer monotherapy. In this study it was obvious that polypharmacy has been reduced from 2002 to 2004. More elderly patients leaved with only one psychotropic drug.