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Short-term use of antipsychotics in older adults with dementia linked to serious adverse events
Date:5/26/2008

Older adults with dementia who receive short-term courses of antipsychotic medications are more likely to be hospitalized or die than those who do not take the drugs, according to a report in the May 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Newer antipsychotic drugs (olanzapine, quetiapine fumarate and risperidone) have been on the market for more than a decade and are commonly used to treat the behavioral and psychological symptoms of dementia, the authors write as background information in the article. Antipsychotic drugs are often used for short periods to treat agitation in clinical practice. They are frequently prescribed around the time of nursing home admission. About 17 percent of individuals admitted to nursing homes are starting on antipsychotic medication within 100 days, and 10 percent receive only a single prescription. Given the widespread use of short-term prescriptions, it is important to evaluate their safety, the authors note.

Paula A. Rochon, M.D., M.P.H., F.R.C.P.C., of the Institute for Clinical Evaluative Sciences (ICES), Ontario, and colleagues studied older adults with dementia living in the community or in nursing homes between 1997 and 2004. In each setting, the researchers identified three groups of equal size who were identical except for their exposure to antipsychotic medications. Among 20,682 older adults with dementia living in the community, 6,894 did not receive antipsychotics, 6,894 were prescribed atypical or newer antipsychotics and 6,894 were prescribed conventional antipsychotics, such as haloperidol or loxaprine. Among 20,559 older adults with dementia living in nursing homes, 6,853 received no antipsychotics, 6,853 received atypical antipsychotics and 6,853 received conventional antipsychotics.

Participants medical records were examined for serious adverse events, defined as hospital admissions and death within 30 days of beginning therapy. Relative to comm
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Contact: Kristine Galka
416-480-4780
JAMA and Archives Journals
Source:Eurekalert

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