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Long-Term Use of Some Antipsychotics Not Warranted in Older Adults: Study
Date:11/28/2012

By Mary Brophy Marcus
HealthDay Reporter

WEDNESDAY, Nov. 28 (HealthDay News) -- The safety and effectiveness of four drugs commonly used to treat older adults with schizophrenia, dementia, bipolar disorder and other mental health conditions are being called into question by a new study.

The drugs -- aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) -- are among medications called atypical antipsychotics and are approved by the U.S. Food and Drug Administration to treat schizophrenia and bipolar disorders.

But physicians often pen off-label prescriptions for people with dementia, post-traumatic stress disorder (PTSD) and other mood disorders to help alleviate symptoms of psychosis as well as anxiety, agitation and aggression.

The medications have been in use since the early 1990s.

The new study, published in the Nov. 27 issue of the Journal of Clinical Psychiatry, involved 332 patients older than 40 who had been diagnosed with an indicated mental health condition and had psychotic symptoms.

"We wanted to see if these drugs were effective and safe for a long period of time," said study author Dr. Dilip Jeste, president of the American Psychiatric Association and a distinguished professor of psychiatry and neuroscience at the University of California, San Diego. He said the risk of cardiovascular disease increases in midlife, and previous research has suggested that this class of drugs can up cardiovascular health risks.

"This is a population in which these drugs are commonly used and in whom the risk of cardiovascular disease is high, and there was no long-term data comparing the drugs," Jeste said. Even though the newer drugs aren't indicated for long-term use except in schizophrenia and bipolar disorder, in practice, Jeste said, they tend to be taken off-label for extended periods of time -- sometimes years.

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