Antipsychotic treatment of dementia leads to small increase in ris...( ng antipsychotics than those who are no...),Health

When the specific drugs were examined individually, there was no significant difference between the risk conferred by one drug over another. And, the researchers note, this increase in risk "could not have been recognized by examining any individual trial. The events were too sparse and the trials too small to be able to meaningfully assess for a dose response that might make attribution even more compelling."

The results of this meta-analysis agree with an April 2005 Food and Drug Administration health advisory which stated that there was "an approximately a 1.61.7 fold increase in mortality" in studies of these drugs, with most due to either heart-related effects like heart failure or sudden death, or infections such as pneumonia.

There are, of course, caveats regarding these results. For instance, most of the studies were relatively short; arguments can be made that the risk might be either higher or lower if looked at over a longer term. And, as Schneider points out, this may not be a risk limited to the atypical antipsychotics. "These are mostly nursing home patients who are frail and medically ill," he points out. "If the same sorts of analyses were done with other drugs--antidepressants, anxiolytics, mood stabilizers, even cardiovascular or antihypertensive drugs--we might see something similar as well. Drugs have side effects, and even as they help, they harm."

For this reason, Schneider says he's concerned that these results will be taken out of context and that there will be an overreaction to the stated risk. "For instance," he says, "it would be wrong to say that because of this effect we should use other medications. It's only because the antipsychotics are the best studied that there were enough patients to be able to see this slight increase in risk of death. T
'"/>

Contact: Jon Weiner
jon.weiner@usc.edu
323-442-2830
University of Southern California
18-Oct-2005