New rules for prescribing psychotropics in nursing homes.

Psychopathology is common in elderly nursing home residents, and the use of psychotropics in this setting is likewise common. According to the current literature, however, such use is not always appropriate. In view of this, the Omnibus Budget Reconciliation Act of 1987 establishes new regulations regarding the use of psychotropics in the nursing home setting. Certain drugs will automatically be considered inappropriate. Excessive dosages and extended use will be scrutinized. Periodically checking blood levels of certain drugs and monitoring for tardive dyskinesia will be required. Psychotropic use must be justified by a bonafide diagnosis for which the drug is indicated and not by a symptom alone. Dosage reductions, medication holidays, and the use of nondrug behavioral treatments will be required.