Off-Label Use of Antipsychotics in Veterans With PTSD, Dementia

HealthDay News — Elderly veterans with post-traumatic stress disorder (PTSD) with dementia have increased odds of being prescribed second-generation antipsychotics (SGAs) compared with those with PTSD alone, according to a study published in the Journal of the American Geriatrics Society.

Todd P. Semla, PharmD, from the Department of Veterans Affairs in Hines, Ill., and colleagues conducted a national cross-sectional study involving 93,068 veterans aged 65 years and older with PTSD with or without concomitant dementia (11.1% with dementia). They examined trends in SGA prescribing in the population.

The researchers found that there was an annual decrease in SGA prescribing between 2004 and 2009, from 7 to 5.1% of elderly veterans with PTSD without dementia and from 13.2 to 8.9% in those with dementia. Over time, the findings consistently showed that veterans with PTSD and dementia vs those without dementia had at least twice the odds of being prescribed an SGA (odds ratios, 2.03 to 2.33).

“The findings were consistent over six years and strongly suggest that providers need to be educated about the complexities of prescribing SGAs to individuals with multiple medical and mental comorbidities,” the authors wrote. “Future work should consider dissemination strategies to better understand why providers practice in this way.”

Disclosures: One author disclosed financial ties to the pharmaceutical industry.


Semla TP, Lee A, Gurrera R, et al. Off-label prescribing of second-generation antipsychotics to elderly veterans with posttraumatic stress disorder and dementia [published online April 3, 2017]. J Am Geriatr Soc. doi:10.1111/jgs.14897