JAMA reported that figure alongside a hopeful trend which is that fewer older adults now take these risky combinations.
For people helping an older family member navigate care, the study also offers a clear reminder that the medication list itself can affect treatment, and deserves attention at every clinical appointment.
What the Study Found
Researchers led by Dima Qato of the University of Southern California analyzed nationally representative data from the National Social Life Health and Aging Project. They compared 2,754 adults ages 62 to 85 surveyed in 2015 to 2016 with 2,186 adults surveyed in 2021 to 2023.
Polypharmacy, defined as regular use of five or more medications or supplements, increased on both fronts. Prescription medication use rose from 31.0 percent to 35.7 percent and supplement use rose from 12.6 percent to 16.7 percent.
The encouraging finding involved potentially major drug interactions. Those combinations fell from 25.7 percent to 22.3 percent. Older adults also used fewer over the counter medications. Use fell from 60.1 percent to 55.1 percent.
Antidepressants and Muscle Relaxants Drive the Risk
The profile of dangerous combinations changed very little. Antidepressants remained the most common ingredient in interacting regimens at 7.21 percent. Statins followed at 5.23 percent and antiplatelet therapy followed at 4.47 percent.
Interacting regimens involving opioid analgesics declined from 5.56 percent to 4.04 percent. Regimens involving benzodiazepines fell sharply from 2.05 percent to 0.87 percent. The authors credit years of efforts to reduce unnecessary use of both drug classes.
Muscle relaxants showed a concerning countertrend. Interacting regimens involving these drugs nearly doubled from 1.35 percent to 2.49 percent. Qato’s group cautioned that this increase may contribute to rising rates of unintentional overdose deaths among older adults.
The authors wrote that although opioid analgesics and benzodiazepines became less common in interacting regimens, muscle relaxants became more common.
They called for greater efforts to identify and manage interacting regimens that involve muscle relaxants among older adults.
The researchers also raised concerns about antidepressant safety. They cited the drug class’s association with serotonin syndrome and arrhythmias. They urged depression treatment guidelines for older adults to prioritize drug interaction screening.
Why Medication Review Belongs in Treatment Decisions
Sedative risk does not disappear when benzodiazepine use declines. Muscle relaxants can also create serious risks when people combine them with opioids sleep aids or alcohol.
An older adult with alcohol use disorder who adds a prescribed muscle relaxant can stack several risks that no single prescriber may see in full.
Additionally, the decline in risky regimens did not happen by accident. Deprescribing initiatives, clinical guidelines and closer scrutiny of benzodiazepine and opioid prescribing helped drive that change. The authors argue that clinicians now need to apply the same discipline to antidepressants and muscle relaxants.
The study has limits. The researchers could not measure actual adverse drug events. Instead they measured the potential for those events. The study also lacked patient level data that can shape individual risk.
Even with those limitations, the study provides a useful picture of where prescribing risks concentrate among older adults.
What This Means for Treatment Seekers
If you or an older family member is considering mental health treatment or addiction treatment, bring a complete list of every prescription supplement and over the counter product to the first appointment.
Ask the prescriber to check for drug interactions. Ask specifically about any muscle relaxant, sleep aid or antidepressant on the list.
Anyone who combines sedating medications with alcohol should raise that issue directly with a medical professional.
Withdrawal from alcohol or benzodiazepines requires medical supervision. An accurate medication list helps clinicians provide that supervision safely.
Exploring Treatment Options
Rehab.com’s directory includes verified treatment centers that provide medication evaluation as part of care.
Some programs can also manage older adults with complex medication regimens. Call
800-985-8516
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to speak with a treatment advisor about programs that coordinate prescribing with therapy.
