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Antipsychotic treatment of dementia leads to small increase in risk of death

Atypical antipsychotic drugs seem to confer a small increased risk for death when used in people with dementia, concludes a team of researchers from the Keck School of Medicine of the University of Southern California in a meta-analysis of 15 clinical trials published in the October 19 issue of the Journal of the American Medical Association.

Despite this risk, says Lon Schneider, M.D., professor of psychiatry, neurology, and gerontology at the Keck School and the USC Andrus School of Gerontology, physicians, families and patients need to keep in mind that psychosis itself is a very serious issue in dementia. "Aggression, hallucinations and delusions in dementia patients can also shorten a patient's life, and result in poor care and rapid deterioration," Schneider says. "It's a difficult problem with no easy answers."

Led by Schneider, the USC researchers analyzed the results of the 15 trials--nine of which are unpublished--to determine whether there was a correlation between the use of these second-generation drugs (the atypical antipsychotics) and an increased risk for death.

Within the 15 trials, four different atypical antipsychotics were assessed and compared with placebo: aripiprazole, olanzapine, quetiapine and risperidone. The trials looked at a total of 3353 patients who took the antipsychotics, as well as 1757 who had been given placebo, and lasted on average between 10 and 12 weeks.

In the final analysis, more patients taking an atypical antipsychotic died during their trial than did patients taking placebo. There were 118 deaths associated with atypical antipsychotics (3.5 percent of the drug arm of the trials) versus 40 deaths associated with placebo (2.3 percent of the placebo arm of the trials). The difference between those two groups was statistically significant, and resulted in an odds ratio of death on antipsychotics versus placebo of 1.54 to 1; in other words, the risk of death is 1.54 times greater for people taki
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Contact: Jon Weiner
jon.weiner@usc.edu
323-442-2830
University of Southern California
18-Oct-2005


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