AGED care medication experts writing in the Australian Prescriber have highlighted the difficulty in determining what constitutes a psychotropic medicine in the context of ensuring their safe and appropriate use in people with cognitive disability or impairment.
"The term has various definitions and meanings and there is considerable debate about which medicines fall into this category," they observed.
The situation is further muddied when antiemetics, medicines for Parkinson's disease, and even nicotine are sometimes incorrectly included in an aged care facility's psychotropic register.
For some, psychotropics are synonymous with the practice of 'chemical restraint', which is now an offence under the Aged Care Act that came into effect last year (PD 07 Nov 2025).
According to guidance from the Aged Care Quality and Safety Commission, the main psychotropic classes include antipsychotics, antidepressants and anxiolytic/hypnotics (e.g. benzodiazepines), with other classes such as anticonvulsants and opioids also included because they are sometimes used off-label to take advantage of their sedating qualities.
Meanwhile, the World Health Organization (WHO) has defined a psychotropic as 'any medicine or substance whose primary or significant effects are on the central nervous system'.
It further differentiates psychotropic medicines, which are primarily used to treat mental health disorders (antidepressants, antipsychotics, anxiolytics, hypnotics and mood stabilisers), from psychotropic substances, which have a high potential for misuse due to their effects on mood, consciousness, or both (cannabis, opioids and stimulants).
"In view of the ambiguity over what medicines to include, consistent Australian adoption of the WHO definition of 'psychotropic' may help rationalise psychotropic registers," the authors suggested.
"Ultimately, ensuring psychotropics are used judiciously in vulnerable older people and those with disability is fundamental to delivering safer, rights-based and genuinely person-centred care."
Read the article HERE. KB
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