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Suboptimal Drug Selection – Multiple CNS-active Agents

Overview

The Suboptimal Drug Selection – Multiple CNS-active Agents TIP was created to address the Pharmacy Quality Alliance measure Polypharmacy: Use of Multiple CNS-active Medications in Older Adults (POLY-CNS). Individuals 65 years of age or older are at a greater risk for side effects while taking three or more CNS-active agents. The goal of the TIP is to consult the prescriber to discontinue or change therapy, so the patient is taking two or fewer CNS-active medications.  

Common CNS-active Agents 

  • Antiepileptic
    • Carbamazepine
    • Divalproex Sodium
    • Gabapentin
    • Lacosamide
    • Lamotrigine
    • Levetiracetam
    • Oxcarbazepine
    • Phenobarbital
    • Phenytoin
    • Pregabalin
    • Topiramate
  • Antipsychotics
    • Aripiprazole
    • Brexpiprazole
    • Cariprazine
    • Chlorpromazine
    • Clozapine
    • Fluphenazine
    • Haloperidol
    • Lurasidone
    • Olanzapine
    • Paliperidone
    • Perphenazine
    • Quetiapine
    • Risperidone
    • Ziprasidone  
  • Benzodiazepines and Nonbenzodiazepine Sedative/Hypnotics

    • Alprazolam
    • Chlordiazepoxide
    • Clobazam
    • Clonazepam
    • Diazepam
    • Estazolam
    • Eszopiclone
    • Lorazepam
    • Temazepam
    • Zaleplon
    • Zolpidem
  • Opioids
    • Buprenorphine
    • Codeine
    • Fentanyl
    • Hydrocodone
    • Hydromorphone
    • Methadone
    • Morphine
    • Opium
    • Oxycodone
    • Oxymorphone
    • Tapentadol
    • Tramadol
  • Serotonin and Norepinephrine Reuptake Inhibitors
    • Desvenlafaxine
    • Duloxetine
    • Levomilnacipran
    • Milnacipran
    • Venlafaxine
  • Selective Serotonin Reuptake Inhibitors
    • Citalopram
    • Escitalopram
    • Fluoxetine
    • Fluvoxamine
    • Paroxetine
    • Sertraline
  • Tricyclic Antidepressants
    • Amitriptyline
    • Amoxapine
    • Clomipramine
    • Desipramine
    • Doxepin
    • Imipramine
    • Nortriptyline

Best Practices

When talking with the prescriber:

  • Use the clinical guidelines and supporting evidence provided in the TIP overview. 
  • Have your recommendation ready, “Based on the other medications the patient is taking, I’d like to recommend (name of medication).” 
  • Keep the patient’s health at the center of the conversation−be prepared to defend your recommendation!  

When talking with the patient:

    • Discuss the benefits of using the suggested medication. 
    • Approach this as an “opportunity to improve your drug therapy” rather than a chance to “fix a mistake the prescriber has made.”  

    Communicate the change to the patient after receiving the prescriber’s approval, “Here is a new medication your doctor has ordered for you.” 

     

     

    Resources: 

    1. By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372