The pattern of central nervous system (CNS)-active drug use has changed from previous years in elderly nursing home residents with epilepsy, a recent study found. Antidepressant use has increased substantially and the CNS side effect profile of these medications and the possible long-term consequences in this population can greatly complicate their therapy. Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes. Prescribing information was available on anti-seizure drugs (ASDs), antidepressant, and antipsychotic drugs on 1 day in October 2013. Researchers found:

• Overall, 66.8% of 18,752 residents received at least 1 CNS-active drug as classified by the Generic Product Identifier classification system.
• For those aged ≥65 years, ASDs were prescribed for 14.3% residents.
• An antidepressant was used in 64.2% of persons prescribed an ASD.
• Antidepressant use varied for specific ASDs and ranged from 50 to 75%.
• An antipsychotic medication was used in 30% of persons prescribed an ASD and ranged from 16.8 to 54.2% for specific ASDs.