General News — 13 September 2012

GPs have a key part to play in tackling the ‘unacceptable’ overprescription of psychotropic drugs in older Australians, according to the peak psychiatry body.

The government’s recognition of dementia as the ninth National Health Priority Area has brought the overuse of antipsychotic medication into the spotlight, particularly in residential aged care.

However, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) claims that overprescription occurs broadly among older Australians and not just among those with dementia or in residential aged care.

“This is unacceptable, but often driven by a lack of access to effective alternatives. Improved access for older people to evidence-based psychological and other non-medication treatments of mental illness is required,” an RANZCP statement read.

Dr Roderick McKay, chair of the RANZCP Faculty of Psychiatry of Old Age, said that time constraints when working in residential care, or demand from families for immediate results, could place pressure on GPs to medicate when not necessary.

“There’s no doubt that overprescription is more common in nursing home settings,” he said. “If medication is needed, clear review periods need to be set.”

The statement followed an ABC Lateline program where it was claimed that thousands of elderly patients may be dying prematurely due to overprescription of antipsychotics.

In a recent MO column, Sydney GP Dr Ray Seidler said anti­psychotics were a last resort when behavioural techniques failed, and that tying GPs’ hands was a recipe for “aged care bedlam”.

Perth GP Dr Joe Kosterich said “rightly or wrongly there is going to be a need for some sort of medication so patients are not going to be a danger to themselves or others”.

“Maybe some of the older-style sedatives such as pericyazine which… have a better safety profile could be more widely used,” he suggested.

As first appeared in the Medical Observer


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