Psychotropic drug use and alcohol drinking in community‐dwelling older Australian men: the CHAMP study

Abstract

Potential psychotropic drug-alcohol interactions were common in older Australian men. Users of sedative or anxiolytic drugs were more likely to engage in daily drinking compared with non-users of sedative or anxiolytic drugs. Clinicians should monitor patients prescribed sedative or anxiolytic drugs for possible adverse events arising from concomitant use with alcohol.

Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes

“…Consistent with those studies investigating psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36], the following drug classes were classified as AI medications, sedatives/hypnotics [18–21, 24, 27, 30, 31], antidepressants [18–21, 27, 30, 31], opioids/narcotics [18–21, 27, 30, 31], anticonvulsants [19–21, 24, 27, 30, 31] and anti-psychotics [19–21, 27, 29, 30]. After CNS agents, cardiovascular medicines (CVS) were the most common AI medicines [18–21, 24, 27, 29–31], followed by antidiabetic drugs [18, 20, 21, 24, 27, 29–31], warfarin [18–21, 24, 27, 30, 31], gastrointestinal agents [18–21, 24, 30, 31], non-steroidal anti-inflammatory drugs (NSAIDs) [18–21, 29–31], antibiotics/anti-infectives [21, 24, 27, 29–31] and anti-histamines [19–21, 30].…”

“…Ten of the included studies were conducted in Europe [14, 19, 21–23, 25, 27–29, 36], eight in North America [18, 20, 24, 30–32, 34, 35] and two in Australia [26, 33]. (Table 1) All studies were cross-sectional [14, 18–36].…”

“…No reference source reportedBeverage specific quantity-frequency, past 2 weeksDel Rio 2002 [22]Spain, community dwelling adults≥ 16 years≥66 years = 1025≥16 years N  = 639648% menNRCross sectional (survey with interview)Benzodiazepine use, past 2 weeksBeverage specific quantity-frequency past 2 weeks: Low (men: ≤ 21 units/week, women: ≤ 14 units/week), moderate (men: 22–50 units/week, women: 15–35 units/week) & high consumption (men: >50 units/week & women: >35 units/week)1 unit = 10 g of alcoholDu 2008 [14]Germany, community dwelling older adults N  = 160545.2% menNRRange: 60–79 yearsCross sectional (survey & interview; prescriptions or original containers)Any psychotropic medication use in past 7 days: ATC nervous system drugs coded N00. (Excluded drugs coded N02B aspirin & paracetamol, except for N02BA71) Opiate codeines used as antitussives were merged with N02A & opiates for GI conditions (A07D) were not recordedBeverage specific quantity-frequency, past 12 months: Problem use (risky drinking): daily consumption ≥10 g for women & ≥ 20 g for menForster 1993 [24]US, community dwelling older adults N =66739.9% men74.1 (±6.6 years)NRCross sectional (survey & interview; medication containers)Prescription or OTC medications currently or past month: AI drugs defined by study clinical team: OTC painkillers, anti-hypertensives, diuretics, OTC cold preparations, arthritis medications, heart medications, antibiotics, mind altering medications, chest pain medications, pain medications, diabetes medications, ulcer medications, sleeping pills, OTC nasal sprays, steroids, blood agents, insulin, seizure medications & OTC asthma medicationFrequency: never, rarely, sometimes & regularlyIlomaki 2008 [25]Finland, community dwelling older adults N =1,77448.1% men63 years (NR)Range: 53-73 yearsCross sectional (mailed survey & interview; prescriptions brought if any problems)Regular use of psychotropic drugs at time of interview: antipsychotics, anxiolytics, hypnotics, sedatives, antidepressants & combinationsBeverage specific quantity-frequency past 12 months: frequent ≥2 times/week, binge (men ≥5 units/occasion: women ≥4 units/occasion) & heavy drinking (men: >14 units/week: women >7 units/week1 unit=12 g of alcoholIlomaki 2013 [26]Australia, community dwelling older men≥70 years N=1,705100% menNRNRCross sectional (Interview: medications brought)Antidepressants (including SSRIS, TCAs, MAOIs and others) & SADs (including benzodiazepines and benzodiazepine-like hypnotics)Beverage specific quantity-frequency past 12 months: daily (7days/week), binge (≥5 drinks at least once/month), heavy (>2 drinks/day) & problem drinkers (CAGE score ≥2). Nondrinkers: former or never drinkers1 drink=10 g of alcoholImmonen 2012 [27]Finland, community dwelling older adults≥ 65 years N=1,39535.5% men78.7 years (NR)NR…”

“…Men and women were included in all studies, with the exception of one Australian study which only included men [26]. Nine studies reported on a wide range of prescription and/or over the counter (OTC) medicines with potential to interact with alcohol [18–21, 24, 27, 29–31] .…”

“…Nine studies reported on a wide range of prescription and/or over the counter (OTC) medicines with potential to interact with alcohol [18–21, 24, 27, 29–31] . Three studies investigated any medication use during the recall period [23, 33, 35], and a further eight focused on psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36]. Of the eight studies focusing on psychotropic medications, five investigated psychotropic medications alone [22, 25, 26, 34, 36] and three studies also included analgesics [14, 28, 32].…”