What is the general Beers Criteria recommendation regarding the number of CNS-active drugs in a patient?

• A. Minimize the number of CNS-active drugs
• B. Avoid all CNS-active medications entirely
• C. Maintain a fixed total of CNS-active drugs
• D. Only use CNS-active drugs when absolutely necessary

Answer: (A)

The Beers Criteria stress that exposure to central nervous system–active medications in older adults should be kept as low as possible. Each additional CNS-active drug can add to sedation, confusion, delirium, and the risk of falls or cognitive decline, so the general guidance is to minimize the total number of CNS-active drugs a patient takes. If a CNS-active medication is needed, use the lowest effective dose and reassess regularly, preferring non-drug or non-CNS strategies when feasible. The other choices aren’t as aligned with the main point: total avoidance of all CNS-active meds isn’t always appropriate, there’s no fixed number to maintain, and while using drugs only when necessary is important, the question specifically targets reducing the number of CNS-active medications.