Læknablaðið - 15.09.1999, Page 11

LÆKNABLAÐIÐ 1999; 85
681
Geðlyfjanotkun á elli-
og hjúkrunarheimilum
á Stór-Reykjavíkursvæðinu árið 1996
Hilmar Kjartansson', Pálmi V. Jónsson2
Kjartansson H, Jónsson PV
Psychotropic use in nursing and residential homes
in the Greater Reykjavík area in 1996
Læknablaðið 1999; 85: 681-90
Introduction: Psychiatric symptoms, with or with-
out dementia, are very common among institutio-
nalized elderly and often treated with medications.
Because of age-related changes in pharmacokinetics
and polypharmacy in this age group, such treatment
is precarious. A recent study showed that use of
psychotropics in Icelandic nursing homes is two to
three times more common than in Sweden and
Denmark.
The goal of this study was to register psychiatric
symptoms, indications for treatment, psychotropic
drug use, dosages and treatment efficacy with quality
in mind.
Material and methods: One hundred and fifteen
individuals in five residential and nursing homes in
the Greater Reykjavík area were evaluated. Fifty
were on three specialized dementia units, and 65 on
two residential units. Information on the number of
psychotropic medications, types, dosages and treat-
ment duration were collected. Nurses, familiar with
the residents, evaluated the symptoms and treatment
efficiacy.
Results: Only 16% were without psychotropic medi-
cations, 39% on one type, 36% on two types and 9%
Frá 'læknadeild Háskóla íslands, 2öldrunarsviði Sjúkrahúss
Reykjavíkur. Fyrirspurnir, bréfaskipti: Hilmar Kjartansson,
Reynimel 74, 107 Reykjavík. Sími: 561 4171, netfang:
hkjartansson @ hotmail.com
Upphaflega unnið sem fjórða árs verkefni læknanema.
Lykilorð: geðlyf, hjúkrunarheimili, geðræn einkenni, auka-
verkanir.
on three types. On the dementia and residential units
there was similar use of antidepressants (30% vs
38%), and hypnotics and tranquilizers (66% vs
71%). On specialized dementia units 62% took
neuroleptic medications but only 15% on residential
units. On residential units the most common
symptoms were sleep disturbances and depression.
Symptoms improved during treatment in 60-98% of
cases according to the caring nurses. In the antide-
pressant drug group dosages or medications had been
chanced in 65% of cases over six months. For the
other groups a change of dose had been made in 45%
of cases over six months. Half of those using antide-
pressant medications received newer types of antide-
pressants. Of those who received hypnotics or tran-
quilizers, 46 individuals received medications with
t'á >20 hours.
Discussion: The use of psychotrophic medications in
the institutionalized elderly is prevalent. The greater
use of antidepressants in Iceland compared to
Sweden and Denmark might suggest better treatment
of depression in Iceland, as many foreign studies
have suggested that depression among the elderly is
underdiagnosed and undertreated. The high use of
hypnotics and tranquilizers, the choice and dosages
however evoke concern considering possible side
effects, such as falls, and raises the question if there
are any altemative non-pharmacologic forms of
treatment.
Key words: psychotropic drugs, nursing homes, psychi-
atric symptoms, side effects.
Ágrip
Inngangur: Geðræn einkenni, tengd eða
ótengd heilabilun, eru algeng meðal vistmanna
á stofnunum fyrir aldraða og oft meðhöndluð
með lyfjum. Vegna aldurstengdra breytinga er
snerta umbrot, útskilnað og milliverkanir lyfja
svo og fjöllyfjanotkunar er slík meðferð vanda-
söm. Rannsóknin Daglegt lífá hjúkrunarheim-
ili sýndi að geðlyfjanotkun á íslenskum stofn-