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This study evaluated the consumption of psychotropic medications by caregivers of elderly patients with or without dementia. This was a cross-sectional study conducted at all geriatric units in Brasília, Brazil, during a two-month period. Structured interviews were performed with 311 caregivers of people with or without dementia and they completed questionnaires. Among the caregivers, 196 (63%) were caregivers of patients with dementia and 115 (37%) were caregivers of patients without dementia. Forty-four caregivers (14.1%) were taking psychotropic drugs (benzodiazepines or antidepressants), and this usage was more frequent among caregivers of patients with dementia (p

Purpose The objective of this study was to assess the frequency of tablet splitting of psychotropic drugs in a population of older adults with a diagnosis of dementia. Methods This retrospective, cross-sectional study examined a sample of geriatric outpatients seen at a public center specializing in the care of elderly patients, a referral center for management of dementias in general, especially Alzheimer dementia to identify the frequency of tablet splitting of psychotropic drugs and the factors that may be involved in this practice. Comparison of the presence or absence of tablet splitting in relation to several parameters was assessed by means of P values; between-group differences with an α P Findings The presence of dementia was significantly associated with prescriptions implying to split tablets, which was found in 88 patients with dementia (34.9%) versus 90 patients without dementia (23.7%) ( P = 0.002). Among the 88 patients with dementia who split tablets, 64 (72.7%) split tablets of psychotropic drugs. Implications These results indicate the importance of identifying the practice of tablet splitting, particularly when it involves psychotropic drugs, because it entails several factors that can reduce the efficacy of the drug therapy.

Sleep disorders (SD) in patients with dementia are very common in clinical practice. The use of antidepressants with hypnotic actions, such as trazodone, plays an important role in these cases. The aim of this study is to present a profile of the use of trazodone in demented patients with SD, as well as a review of trazodone hydrochloride in SD. We evaluated 178 elderly patients with Alzheimer’s disease and other dementias, clinically presenting SD and treated with hypnosedative medications. In the one-year period comprising the study, 68 (38.2%) of the 178 had sleep disorders. Most patients (114; 64%) had a diagnosis of Alzheimer’s disease. Approximately 85% of patients with SD used hypnosedative drugs. Trazodone was the most commonly used drug among patients (N = 35), with an effectiveness of 65.7%. Trazodone has been shown to be a good option for treatment of the elderly with dementia and associated SD. _________________________________________________________________________________________________________________ RESUMO Distúrbios do sono (DS) em pacientes com demência são muito comuns na prática clínica. O uso de antidepressivos com ação hipnótica, como a trazodona, tem um papel importante nesses casos. O objetivo desse estudo é apresentar um perfil do uso da trazodona em pacientes com demência e com DS, bem como revisar o cloridrato de trazodona no DS. Nós avaliamos 178 idosos com doença de Alzheimer (DA) e outras demências, clinicamente apresentando DS e que foram tratados com medicações hipnossedativas. No período de um ano de estudo, 68 (38,2%) tiveram DS. A maioria (114; 64%) tinham diagnóstico de DA. Aproximadamente 85% usaram fármacos hipnossedativos. A trazodona foi a mais utilizada (N=35), com evidência de melhora de 65,7%. A trazodona mostrou-se ser uma boa opção no tratamento de idosos com demência e DS associado.

Chronic cough caused by interstitial pneumopathy can present a therapeutic dilemma, and the use of tramadol in the treatment of this symptom might be an alternative to improve the quality of life in patients. The present study describes a patient with rheumatoid arthritis and interstitial lung disease lasting 11 years who developed dry cough secondary to interstitial pneumopathy but was nonresponsive to several treatments (codeine 20 mg q6h; clobutinol 240 mg/d; and dextromethorphan 10 mg q4h).The purpose of this study was to investigate, for an individual patient, the effectiveness of tramadol 50 mg compared with placebo, and whether tramadol provided any antitussive benefit.This was an N-of-1 double-blind, randomized controlled trial of tramadol against placebo. Treatment was administered in 3 pairs, each consisting of 2 periods in which either tramadol 50 mg BID or placebo was administered for 6 days, followed by a 2-day washout period, and then the administration of the alternate for 6 days. A 2-day washout period was also carried out after pairs 1 and 2. Per pair, the sequence of treatments was randomized. Outcome measures were: the intensity of daytime and nighttime cough, assessed by a visual analog scale (VAS) ranging from 0 to 5 (0 = no cough, 5 = distressing cough); and the patient's perception regarding her health state (better, same, or worse).A 55-year-old black woman (height, 153 cm; weight, 71 kg) was in the study. In all treatment pairs, cough intensity, as reported by the patient using the VAS, was significantly lower with tramadol compared with placebo (P0.001), both in the daytime (2 vs 5, respectively) and at nighttime (1 vs 4). Regarding the patient's health state, in all periods in which tramadol was administered, the patient reported feeling better than when placebo was administered. At the begin- ning of pair 2, the use of rescue tramadol 50 mg (un-blinded) was permitted due to cough intensity. In the remaining treatment periods in which placebo was administered, rescue tramadol was administered, whereas rescue tramadol was not needed during the periods in which tramadol was administered.Tramadol appeared to be effective in controlling cough in this patient. Because no similar report was found in the literature, further studies assessing the efficacy of tramadol as an antitussive agent are warranted.

O artigo teve por objetivo comentar estudos sobre polifarmácia em idosos, particularmente em diagnose e controle. O conceito de polifarmácia considera o uso de diversos medicamentos ao mesmo tempo, além da utilização de um fármaco para corrigir o efeito adverso de outro. Por consumirem mais medicamentos para o tratamento de diversas doenças, os idosos são mais vulneráveis ao surgimento de reações adversas. Medidas profi láticas, como a prescrição balanceada, são de fundamental importância para diminuir essas reações, tendo em vista o aumento do tempo de internação, gasto e piora do quadro de saúde do idoso. The article had the purpose of commenting on studies on polypharmacy in the elderly, focusing on diagnosis and control. Polypharmacy is defi ned as the use of a number of medications at the same time and the use of additional drugs to correct drug adverse effects. The fact that the elderly take more medications for the treatment of several diseases makes them more susceptible to the occurrence of adverse reactions. Prophylactic actions such as balanced prescriptions are vital to reduce the incidence of these reactions and prevent longer hospital stay, increased costs and aggravation of the elderly health condition.