Follow Forum_Psych on Twitter

Display results as :

Rechercher Advanced Search

We have 222 registered users
The newest registered user is raheelmemon

Our users have posted a total of 1140 messages in 613 subjects
If you are seeing this, you have attempted to link to the UpToDate widget but are experiencing a problem. Please visit UpToDate for more information.

Differences in Mortality Risks of Various Antipsychotics in Nursing Home Patients

Go down

Differences in Mortality Risks of Various Antipsychotics in Nursing Home Patients

Post  Admin on Sat May 12, 2012 5:37 pm

Differential risk of death in older residents in nursing homes prescribed specific antipsychotic drugs: population based cohort study.
BMJ. 2012 Feb 23;344:e977

To assess risks of mortality associated with use of individual antipsychotic drugs in elderly residents in nursing homes.

Population based cohort study with linked data from Medicaid, Medicare, the Minimum Data Set, the National Death Index, and a national assessment of nursing home quality.

75,445 new users of antipsychotic drugs (haloperidol, aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone). All participants were aged ≥ 65, were eligible for Medicaid, and lived in a nursing home in 2001-5.

Cox proportional hazards models were used to compare 180 day risks of all cause and cause specific mortality by individual drug, with propensity score adjustment to control for potential confounders.

- Compared with risperidone, users of haloperidol had an increased risk of mortality (hazard ratio 2.07, 95% confidence interval 1.89 to 2.26) and users of quetiapine a decreased risk (0.81, 0.75 to 0.88). (Haloperidol >> Risperidone >> Quetiapine)
- The effects were strongest shortly after the start of treatment, remained after adjustment for dose, and were seen for all causes of death examined.
- No clinically meaningful differences were observed for the other drugs.
- There was no evidence that the effect measure modification in those with dementia or behavioural disturbances.
- There was a dose-response relation for all drugs except quetiapine.

- Though these findings cannot prove causality, and we cannot rule out the possibility of residual confounding, they provide more evidence of the risk of using these drugs in older patients, reinforcing the concept that they should not be used in the absence of clear need.
- The data suggest that the risk of mortality with these drugs is generally increased with higher doses and seems to be highest for haloperidol and least for quetiapine.

Click on to post your comments

Posts : 948
Points : 2102
Reputation : 0
Join date : 2011-02-19
Location : Philadelphia

Back to top Go down

Back to top

- Similar topics

Permissions in this forum:
You cannot reply to topics in this forum