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Research Letter
Less Is More
February 13, 2017

Trends in Central Nervous System–Active Polypharmacy Among Older Adults Seen in Outpatient Care in the United States

Author Affiliations
  • 1Department of Psychiatry, University of Michigan, Ann Arbor
  • 2Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
  • 3Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 4Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
  • 5New York State Psychiatric Institute, New York
JAMA Intern Med. Published online February 13, 2017. doi:10.1001/jamainternmed.2016.9225

With each new revision of the Beers Criteria, the list of psychotropic medications considered potentially inappropriate in the elderly has grown. Opioids have recently been included in a Beers measure of central nervous system (CNS) polypharmacy.1 Prescribing related drug combinations also received increased regulatory attention when the US Food and Drug Administration recently ordered a black-box warning to alert patients of serious risks, including death, caused by opioids coprescribed with CNS depressants. While evidence builds concerning harms of CNS polypharmacy, little is known about the trends in relevant prescribing practices.

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