Despite concerted efforts in recent years to decrease antipsychotic prescribing in post-acute and long-term care, a new study indicates that antipsychotic prescriptions in nursing homes and assisted living facilities actually have increased 1.5% since the pandemic’s start. Not surprisingly, the highest number of prescriptions for these medications occurred in the first quarter of the pandemic.

Prescriptions for four of the five most commonly prescribed antipsychotics increased in 2020 and 2021. The largest increase was for aripiprazole (Abilify), with an increase of 14%. Haloperidol (Haldol) and olanzapine (Zyprexa) prescriptions also went up during this time period. At the same time, quetiapine (Seroquel) and risperidone (Risperdal)  had similar or lower levels of prescriptions compared to pre-pandemic numbers.

The study authors admitted that the pandemic “created considerable challenges and hardships” for long-term care facilities and their residents. They suggested that their findings raise questions about the short- and long-term effects on quality of life and health outcomes for residents who take these medications. “Given the known drop in nursing home resident census – and likely drop in overall LTCF census – during 2020 and 2021, the increase in antipsychotic prescriptions per resident may be even larger,” they observed.

Further study on this, the authors said, could put more light on this issue, specifically regarding nursing home residents with dementia and other common comorbidities. This would help clinicians understand the reasons for changes and disparities in antipsychotic prescribing, as well as the impact on resident care and outcomes.

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