A new large study from Finland has revealed that many older adults are being prescribed strong psychiatric medications for reasons not officially approved by medical guidelines.
These medicines, known as antipsychotics, are designed to treat serious mental illnesses such as schizophrenia and severe bipolar disorder. However, the research shows that they are often given to older people for other problems, including sleep difficulties and behavioral symptoms, even when safer options might exist.
The study was conducted by researchers from the University of Oulu and the University of Eastern Finland. They examined national health records of more than 209,000 older adults living at home who did not have Alzheimer’s disease.
By analyzing this large dataset, the scientists were able to compare three groups: those taking antipsychotics for approved medical reasons, those using them for unapproved purposes, and those not taking these medications at all. Their findings were published in the Nordic Journal of Psychiatry.
The results showed that about 70 percent of antipsychotic use among these older adults was off-label, meaning the drugs were prescribed for conditions not officially listed in the drug’s instructions.
This type of use has been increasing over time. The medications most commonly used in this way were risperidone and quetiapine, both powerful drugs that affect brain chemistry.
Doctors sometimes prescribe these medicines to help manage agitation, anxiety, restlessness, or sleep problems in older patients. These symptoms can be difficult to treat, especially when a person has multiple health issues or limited access to specialized care.
In busy healthcare systems, medication may be used as a quick solution when other treatments such as counseling, behavioral therapy, or environmental changes are not available.
However, antipsychotics can cause serious side effects, particularly in older adults. These may include weight gain, diabetes, heart problems, movement disorders, and increased risk of stroke. Because of these risks, guidelines usually recommend using them only when absolutely necessary and under careful monitoring.
The Finnish study found that older adults using antipsychotics off-label were more likely to have heart and blood vessel diseases than those using the drugs for approved reasons.
They also had a higher rate of cerebrovascular conditions, which affect blood flow to the brain and can lead to strokes. In addition, many off-label users were also taking opioid pain medications, which can further increase health risks.
Researchers were surprised that people receiving these drugs for unapproved reasons often had more physical health problems than those using them for severe psychiatric conditions.
This raises concerns that the medications may not be monitored as carefully when prescribed off-label. Without proper supervision, side effects could go unnoticed until serious complications occur.
The findings also highlight broader issues in elderly care. Limited staffing, lack of access to non-drug therapies, and the complexity of treating older patients may contribute to reliance on medication. Some experts have even suggested that using powerful drugs without trying safer alternatives first could be harmful and ethically questionable.
The researchers stress the need for better treatment options for symptoms such as insomnia, agitation, and behavioral changes in older adults.
Non-drug approaches, including improving sleep routines, increasing social support, adjusting living environments, and providing psychological care, may help reduce the need for these medications. Clearer guidelines and better monitoring systems are also necessary to ensure patient safety.
In conclusion, this study sheds light on a widespread practice that carries significant risks. While antipsychotic medications can be life-saving for certain mental illnesses, their use for other purposes in older adults should be carefully evaluated.
Doctors, caregivers, and healthcare systems must work together to find safer solutions and ensure that older people receive care that protects both their mental and physical health.
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