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Antipsychotic medications linked to deaths
in Elderly Patients
Newswise — Elderly patients who are
prescribed a conventional, or
first-generation, antipsychotic medication
are at an increased risk of death from
cardiovascular or respiratory diseases as
compared to those who take an atypical, or
second-generation, antipsychotic medication,
according to a study funded by the Agency
for Healthcare Research and Quality.
The new study, “Potential Causes of Higher
Mortality in Elderly Users of Conventional
and Atypical Antipsychotic Medications,”
recently posted online in the Journal of the
American Geriatrics Society, adds to growing
evidence that conventional antipsychotics
may not be safer than atypical
anitpsychotics for the elderly.
Researchers
had previously identified that such
second-generation medications may pose
increased mortality; the new study compares
specific causes of death among elderly
patients newly started on conventional vs.
atypical antipsychotics.
Elderly patients are often prescribed
antipsychotic medications to treat mental
health symptoms and related conditions.
These medications are commonly prescribed to
Medicare patients in nursing homes.
In recent years, clinicians have
increasingly prescribed second-generation
medications that generally have fewer
neurological side effects than
first-generation antipsychotics.
In 2005, after studies suggested
second-generation antipsychotics increased
the risk of death by 60 percent in elderly
patients with dementia, the FDA issued a
public health advisory, which did not extend
to first-generation antipsychotics.
The new study, however, provides additional
evidence of the risks associated with
first-generation versions for elderly
patients. While this study does show an
association with cardiovascular deaths,
further studies will be needed to confirm
this association.
Authors examined records of all seniors in
British Columbia who took either
first-generation or second-generation
antipsychotics between 1996-2004, including
12,882 patients who commenced use of
conventional and 24,359 patients who began a
regimen of atypical antipsychotic
medications.
Of 3,821 total deaths within the first 180
days of use, cardiovascular deaths accounted
for 49 percent of the excess deaths.
The study was completed by researchers at
the Brigham and Women’s Hospital DEcIDE
(Developing Evidence to Inform Decisions
about Effectiveness) team in Boston.
That team is one of 13 nationwide that are
part of the AHRQ’s Effective Healthcare (EHC)
program. For more information about DEcIDE
and the EHC program, go to
http://www.effectivehealthcare.ahrq.gov.
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