Trends in antiepileptic, antipsychotic, and opioid prescribing to nursing home residents with dementia

An analysis in the Journal of the American Geriatrics Society found that between 2015 and 2019, an increasing proportion of US nursing home residents with Alzheimer's Disease and related dementias (ADRD) were prescribed antiepileptics, while antipsychotic and opioid prescribing rates declined.

Also, residents with ADRD and disruptive behaviors were more likely to receive valproic acid (an antiepileptic used as a mood stabilizer), while those with reported pain were more likely to receive gabapentin (an antiepileptic approved to treat nerve pain following shingles but widely prescribed for other pain conditions).

"Policy-wise, antiepileptics are flying under the radar. Because the evidence base for antiepileptics is relatively weak for both the behavioral and psychological symptoms of dementia and for most pain conditions, these prescribing trends warrant more attention," said corresponding author Molly Candon, Ph.D., of the University of Pennsylvania.