Experts are clear that people aged 65 years or older should not simultaneously take three or more medicines that target the brain or CNS.

Such drugs often interact, potentially accelerating cognitive decline and increasing the risk of injury and death.

This guidance is especially relevant to people with dementia, who often take multiple pharmaceuticals to address their symptoms.

A recent study involving people with dementia found that almost 1 in 7 of the participants are taking three or more brain and CNS medications, despite experts’ warnings.

While the United States government regulates the dispensing of such medication in nursing homes, there is no equivalent oversight for individuals living at home or in assisted-living residences. The recent study focused on individuals with dementia who are not living in nursing homes.

The lead author of the study, geriatric psychiatrist Dr. Donovan Maust of the University of Michigan (UM) in Ann Arbor, explains how an individual can end up taking too many medications:

“Dementia comes with lots of behavioral issues, from changes in sleep and depression to apathy and withdrawal, and providers, patients, and caregivers may naturally seek to address these through medications.”

Dr. Maust expresses concern that too frequently, doctors prescribe too many medications. “It appears that we have a lot of people on a lot of medications without a very good reason,” he says.

The study paper appears in JAMA.

The medications of 1.2 million people

For the study, UM researchers examined the prescription of sleep medications, antipsychotics, antidepressants, opioid pain relievers, and anti-seizure drugs for nearly 1.2 million people with dementia, using their 2018 Medicare records.

While younger people may safely use these medications together, the concern is that age-related and dementia-related changes in brain chemistry may result in undesirable interactions.

Of the people in the study, 13.9% took three or more CNS-related medications for more than 1 month, which the study authors describe as “CNS-active polypharmacy.”

Prescriptions for these medications were common, with 831,017 individuals having received at least one of the drugs at least once during the year. Almost half of those studied — 535,180 — took one or two of these medications for more than 1 month.

Medical reference: Medical News Today