Author's reply: To PMID 25370543.

Sir,

We appreciate the insights from Bhad and Hazari.[1] The issue of polypharmacy in the elderly population is of increasing importance due to the rapidly aging population — A phenomenon of truly global proportions.[23] While the present study identifies several combinations of pre-injury cardiac and neuropsychiatric medications that may be associated with increased mortality following trauma, it is important to note that this paper is purely descriptive in nature and that no causative effect is claimed by the study team.[4] The authors would like to emphasize that they fully recognize limitations of the present study and have cautioned readers in the discussion about the generalizability of the findings. These data are reported purely as preliminary findings in a clinical area with little to no previous investigation along the current line of scientific inquiry.[4] We echo Bhad and Hazari's sentiment that the overarching issue at hand is not necessarily isolated to the use of neuro-psychiatric or cardiac medications but rather to the emerging phenomenon of polypharmacy and the secondary effects of multi-medication regimens that we are just now beginning to more fully appreciate.[56] We also agree that many of the patients taking neuro-psychiatric medications may not have been previously able to participate in activities that many others in the society take for granted, and have thus tremendously benefited from both the availability improving efficacy of these pharmaceutical agents.[789] Having said that, it is important to emphasize that the associations noted in the current study[4] are unlikely to be present purely by chance and that further investigation within this specific area is certainly warranted.