A longitudinal study of psychotropic prescriptions in a teaching nursing home

Article Abstract:

The results of previous studies have indicated that psychotropic drugs, medications used for the treatment of mental illness, are frequently prescribed for the elderly in nursing homes. Estimates of psychotropic drug prescriptions among this group range from 11 to 74 percent. These results require further investigation because of this wide range of variability, and also to further examine the patterns of drug prescribing over time. This longitudinal study consisted of 91 residents of a 200-bed nursing home that was also a geriatric and psychiatric teaching facility affiliated with a medical college. The patients ranged in ages between 54 and 103, and the average age was 85 years old. Data on prescription frequency, the number of prescriptions, and individual doses were collected over a five-year period. All psychiatric diagnoses which accompanied the psychotropic medications were also reviewed. The results of the five-year analysis revealed that 70 percent of the patients were given a psychotropic drug, but fewer than 25 percent received continuous medication during this period. Episodic administration of psychotropic drugs was more common than continuous use among those who received these drugs. It is believed that this report represents the first longitudinal study of psychotropic drug prescribing and usage patterns among elderly nursing home residents. Other factors that may be indicative of the quality of treatment among nursing home residents which require more research include the incidence of drug reactions, drug efficacy, and the association of these drugs with adverse events, such as falls, fractures, and fainting. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Aged, Elderly, Dosage and administration, Psychotropic drugs, Nursing home patients

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Serum nortriptyline levels in nursing mothers and their infants

Article Abstract:

About 10 to 15 percent of postpartum women suffer from depression. However, there have been few reports in the literature of drugs evaluated for treating postpartum depression. One potential complication is that the infant will be adversely affected by the drug, if the mother is breast feeding her child. Also, the mother may not absorb the drug as she normally would because of the physiological changes in her body due to childbirth and nursing. In the present paper, seven postpartum women suffering from depression were treated with nortriptyline, an antidepressant medication. The healthy infants were aged six months or less. After a minimum of 15 days at a stable dose of the drug, blood samples were taken from mothers within three hours of nursing their infants; blood samples were also taken from the infants at this time. Even though the blood levels in the mothers were clinically effective, no infant had a detectible level of nortriptyline in his blood. This suggests that nortriptyline was not passed to the baby in breast feeding. In the blood of two of the youngest infants, a less active byproduct of nortriptyline, 10-hydroxynortriptyline, was found. However, no adverse effects in any infant were observed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Postpartum depression, Drug therapy, Breast feeding, Nortriptyline

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Putting poor mothers to work

Article Abstract:

The new welfare law, which Pres. Clinton signed in Aug. 1996, was designed to oblige women on welfare to work for their benefits. Congress created the new law without taking into account the needs of young children and the competing demands of work and family face by poor women. Although the welfare reform legislation recognizes the presence of violence on low-income women, it gives little consideration to the stresses of everyday life associated with poverty.

Editorial, Evaluation, Employment, Welfare reform, Poor women, Single mothers

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