Post-acute neuropsychiatric symptoms triggered by COVID-19 could raise the long-term use of multiple psychoactive drugs in older nursing home residents, a new study has found.
Signs of depression, anxiety, agitation and fatigue were among the most commonly observed symptoms among long-term care residents with COVID. These symptoms led to an increase in medication use for adults 65-years and older, according to the research featured in the _Canadian Geriatrics Journal_.
“SARS-CoV-2 infection was associated with a greater number of psychotropic medication prescriptions, in particular antidepressant medication,” the authors noted. “These results suggest that COVID-19 may promote psychotropic medication prescription that contributes to polypharmacy in frail older adults living in a long-term care facility.”
Investigators said findings emphasized that prescribers must be especially careful when ordering medications for infected patients.
Follow-up studies showed that older adults were also at a greater risk for post-acute illnesses compared to their younger counterparts, especially those who already had two or more long-term health conditions.
Subjects included adults 65-years-old and older across six Canadian nursing homes. Nearly 74% of participants had had COVID.
Participants also had to “experience a significant loss of autonomy and require more than three hours of direct care per day.” Neuropsychiatric symptoms were analyzed using the Neuropsychiatric Inventory (NPI) – nursing home version.
Similar studies have been performed to determine whether a COVID infection could impact the way and frequency in which clinicians prescribe medications, and whether that plays a role in the long-term health and well-being of seniors.
A separate [study](https://www.mcknights.com/news/study-ltc-residents-with-covid-19-at-risk-for-polypharmacy-new-drug-interactions/) in the _Journal of Post-Acute and Long-Term Care Medical Association_ found that residents who had a COVID diagnosis across 41 Texas nursing homes saw an increase in the number of medications they were taking. They were also exceptionally vulnerable to post-acute illnesses.
Over a six-month period, researchers examined several factors, including new medications, increases in dosage and drug-drug interactions. They found that more than half of the residents with COVID-19 were treated with new medications, and that an average of 2.6 drugs were initiated.
In addition, approximately one-third of the original study cohort had at least one new medication still recorded at 30 days after their COVID-19 diagnosis. Nearly 20% experienced clinically significant drug-to-drug interactions.
As a solution, authors of the _Canadian Geriatrics_ [study](https://pmc.ncbi.nlm.nih.gov/articles/PMC11882206/) urged clinicians to think twice about whether the medications they’re prescribing are medically necessary.
“Clinicians should reassess the need for psychotropic medication prescribed following a SARS-CoV-2 infection, and implement deprescribing strategies when appropriate,” the authors said.