Abstracts

Rationale: Rationale: The incidence of epilepsy is the highest in the elderly population and the prevalence of epilepsy is higher in nursing home residents than in the community-dwelling population. In addition, co-medications that act in the central nervous system (CNS) are frequently prescribed in nursing home residents. The objective of our study was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of antipsychotic and antidepressant medications in these elderly nursing home residents receiving ASDs.Methods: Methods: The data for this study was obtained from a pharmacy database serving Minnesota and Wisconsin nursing homes. We obtained the prescription information records for all ASDs, antidepressant and antipsychotic drugs on one day (October 2013; n= 18,752 patients). Descriptive statistics were performed to determine the frequency distribution by age, gender, formulation type, trademarked/generic drugs, route of administration, and multiple drug combinations.Results: Results: Overall, drugs classified as ASDs were prescribed for 16.1% of 18,752 residents. Of the ASDs, gabapentin comprised 8.0 %; valproate 3.32 %; levetiracetam 2.05 %; phenytoin 1.02 %; and pregabalin 0.67 %. An antidepressant was used in 65% of persons prescribed an ASD, but only in 29% of those not on ASDs. Antidepressant use varied for specific ASDs and ranged from 49.5 to 75.1 %. An antipsychotic medication was used in 32% of persons prescribed an ASD and ranged from 19.8 toConclusions: Conclusion: The pattern of CNS active drug use has changed from previous years in this geographic region. Use of phenytoin has declined, but antidepressant use has increased more than 3 fold compared to a previous survey from this region (1). Antidepressant and antipsychotic medications are used commonly with ASDs. There were twice as many residents receiving both an ASD and antidepressant compared to those receiving an antidepressant alone. These CNS active drugs have the potential for both pharmacokinetic and pharmacodynamics interactions that may affect the efficacy and side effects in this vulnerable population. 1. Lackner, T.E., Cloyd, J.C., Thomas, L.W., Leppik, I.E., 1998. Antiepileptic drug use in nursing home residents: effect of age, gender, and comedication on patterns of use. Epilepsia 39, 1083-1087.