Changes in psychotropic prescription medication use and their relationship with mortality among people with traumatic spinal cord injury.

STUDY DESIGN: Prospective cohort study.

OBJECTIVE: To identify the relationship of frequency of prescription medication use to treat pain, spasticity, sleep, and depression/stress, and change in prescription medication use with risk of all-cause mortality.

SETTING: This study was initiated at a specialty hospital in the Southeastern USA, with follow-up and data analysis at an academic medical center in the Southeastern United States.

METHODS: Prospective data were collected in 1997-1998 (Time 1) and 2007-2009 (Time 2), with mortality determined as of 31 December 2014. The initial participant cohort was comprised of 1386 participants with traumatic SCI who were adults and a minimum of 1-year post-injury at enrollment in 1997-1998. Of these, 863 participated at follow-up and 861 were included in the current mortality analysis.

RESULTS: The frequency of taking prescription medication increased over the 10-year timeframe, particularly for sleep and pain. Each type of prescription medication at Time 1 was associated with later mortality, and an increase in medication use over time was associated with a greater risk of mortality for three of the four conditions (all except spasticity). A decrease in the frequency of pain medication use over time was associated with a decreased risk of all-cause mortality.

CONCLUSIONS: More frequent use of prescription medication to treat pain, sleep, and depression/stress is related to all-cause mortality, and increases in the use of medications to treat these conditions is associated with elevated risk of all-cause mortality.