TITLE

Risk of death associated with the use of conventional versus atypical antipsychotic drugs among elderly patients

AUTHOR(S)
Schneeweiss, Sebastian; Setoguchi, Soko; Brookhart, Alan; Dormuth, Colin; Wang, Philip S.
PUB. DATE
February 2007
SOURCE
CMAJ: Canadian Medical Association Journal;2/27/2007, Vol. 176 Issue 5, p627
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Public health advisories have warned that the use of atypical antipsychotic medications increases the risk of death among elderly patients. We assessed the short-term mortality in a population-based cohort of elderly people in British Columbia who were prescribed conventional and atypical antipsychotic medications. Methods: We used linked health care utilization data of all BC residents to identify a cohort of people aged 65 years and older who began taking antipsychotic medications between January 1996 and December 2004 and were free of cancer. We compared the 180-day all-cause mortality between residents taking conventional antipsychotic medications and those taking atypical antipsychotic medications. Results: Of 37 241 elderly people in the study cohort, 12 882 were prescribed a conventional antipsychotic medication and 24 359 an atypical formulation. Within the first 180 days of use, 1822 patients (14.1%) in the conventional drug group died, compared with 2337 (9.6%) in the atypical drug group (mortality ratio 1.47, 95% confidence interval [CI] 1.39-1.56). Multivariable adjustment resulted in a 180-day mortality ratio of 1.32 (1.23-1.42). In comparison with risperidone, haloperidol was associated with the greatest increase in mortality (mortality ratio 2.14, 95% CI 1.86-2.45) and loxapine the lowest (mortality ratio 1.29, 95% CI 1.19-1.40). The greatest increase in mortality occurred among people taking higher (above median) doses of conventional antipsychotic medications (mortality ratio 1.67, 95% CI 1.50-1.86) and during the first 40 days after the start of drug therapy (mortality ratio 1.60, 95% CI 1.42-1.80). Results were confirmed in propensity score analyses and instrumental variable estimation, minimizing residual confounding. Interpretation: Among elderly patients, the risk of death associated with conventional antipsychotic medications is comparable to and possibly greater than the risk of death associated with atypical antipsychotic medications. Until further evidence is available, physicians should consider all antipsychotic medications to be equally risky in elderly patients.
ACCESSION #
24091846

 

Related Articles

  • Guidelines for improving assessment skills. King, Colleen // Generations;Spring97, Vol. 21 Issue 1, p73 

    Presents guidelines in assessing the needs of older people. Necessity of spending time to develop rapport with the client; Need to avoid bias and difficult situations; Key to the successful comprehensive assessment of a client; Use of the comprehensive assessment interview as a valuable tool in...

  • Editorial. Iphofen, Ron // Quality in Ageing;Dec2004, Vol. 5 Issue 4, p2 

    Introduces a series of articles about the care of older people.

  • Geriatric medicine.  // British Medical Journal (Clinical Research Edition);7/17/1982, Vol. 285 Issue 6336, p181 

    Focuses on geriatric medicine. Components of aged care; Common ailments among the aged; Significance of holistic care in geriatric medicine.

  • LETTERS TO THE EDITOR. Williams, Henry J.; Schold Davis, Elin // Today's Geriatric Medicine;Jul/Aug2013, Vol. 6 Issue 4, p5 

    Two letters to the editor are presented in response to articles "The Geriatric Medicine Paradox," in the March/April 2013 issue, and "Helping Elders Retire From Driving," in the March/April 2013 issue.

  • Bringing a Generalist Approach to the Problems of Older Patients. Kovinsky, Kenneth E. // JGIM: Journal of General Internal Medicine;Sep2000, Vol. 15 Issue 9, p673 

    This issue of JGIM has three articles dealing with issues principally affecting the care of older patients: functional decline after hospitalization, end-of-life decision making, and reporting of impaired drivers.1-3 It may seem unusual that a journal for general internists would have so much...

  • Program examines links between elderly and ER. Bonvissuto, Kimberly // Crain's Cleveland Business;12/06/99, Vol. 20 Issue 49, p13 

    Focuses on the Systematic Intervention for a Geriatric Network of Evaluation and Treatment, a program in Cleveland, Ohio that coordinate strategies to treat the elderly. Emergency departments that participate in the program; How the program works; Significance of the program.

  • Changing the technology of assessing the elderly: The example of the R.A.I. Fries, Brant E. // Generations;Spring97, Vol. 21 Issue 1, p59 

    Discusses how to design an instrument to provide accurate and reproducible data in assessing the elderly. Focus on the National Resident Assessment Instrument for nursing homes; Ways to improve an assessment process; Components of computerized assessment systems.

  • Cross-cultural geriatric ethics: Negotiating our differences. Moody, Harry R. // Generations;Fall98, Vol. 22 Issue 3, p32 

    Determines the differences of solutions to ethical problems in geriatric care in a cross-cultural perspective. Commonalities among ethnic groups regarding aging; Cultural differences in elderly care; Historical background on the geriatric health profession.

  • Intermediate care-a good thing? Steiner, Andrea // Age & Ageing;Aug2001 Supplement 2, Vol. 30, p33 

    Provides information on a study which proposed the development of intermediate care concept in Great Britain for older adults. Overview of the concept of intermediate care; Models; Methodology; Implications, opportunities and challenges of the intermediate care concept.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics