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Antipsychotic drugs increase risk of death in older people with dementia

PHILADELPHIA, June 5, 2007 - A new study shows that use of antipsychotic drugs is associated with an early and sustained increase in risk of death when used to treat disruptive behavior of older adults with dementia.

The study suggests that both newer atypical antipsychotics and older conventional antipsychotics are associated with increased mortality. The highest risk appears to involve use of the older conventional drugs.

Antipsychotic drugs are approved for treating psychotic conditions such as schizophrenia and mania. But they are widely prescribed to manage behavioral symptoms of dementia, such as agitation, verbal or physical aggression and delusions, hallucinations or paranoia.

Our study adds to mounting concerns about the use of antipsychotic drugs in dementia, said Sudeep Gill, MD, MSc, a geriatric medicine specialist and the studys lead author.

The FDA and Health Canada both issued warnings in 2005 that use of newer atypical antipsychotics to treat elderly patients with dementia was associated with an increased risk of death. But Dr. Gill said, Previous trials have generally been very short and could not provide information about the long-term impact of antipsychotics on death. And relatively little information has been available on the harms associated with the older conventional or typical antipsychotics.

Investigators in the new study linked four administrative health care databases to look at health and death records of more than 27,000 people age 66 and older diagnosed with dementia between April 1, 1997, and March 31, 2002.

The investigators found:

  • Estimated mortality rate among study participants was high, especially in the long-term care setting.

  • Conventional antipsychotics were associated with higher risk for death than atypical antipsychotics, and atypical antipsychotics were associated with higher risk for death than no antipsychotic use.

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Contact: Susan Anderson
sanderson@acponline.org
215-351-2653
American College of Physicians
4-Jun-2007


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