Trends in Antipsychotic and Mood Stabilizer Prescribing in Long-Term Care in the U.S.: 2011-2014.

The sample was built from Medicare claims, not nursing home assessments, and included only residents with continuous Medicare fee-for-service and Part D coverage, so it misses Medicare Advantage beneficiaries and prescriptions outside Part D. Residents with schizophrenia, Tourette’s syndrome, and Huntington’s disease were excluded from the primary analysis, so it does not describe prescribing in those groups. Claims show fills, not whether residents actually took the medication, and they do not show why it was prescribed, such as for dementia behavior, depression, bipolar disorder, or pain. The study did not capture non-drug strategies or physical restraint use, so it cannot show what else changed alongside medication trends. The analysis ends in 2014 and does not include later prescribing trends.

The authors declared no conflicts of interest. The article’s publication types list NIH extramural and non-U.S. government research support.

Do not read the fall in antipsychotic prescribing as proof that prescribing became more appropriate. Mood stabilizer use rose, especially gabapentin, and the data lack prescribing indication and actual medication use.