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. 2022 Feb 19;12(2):298-307.
doi: 10.5498/wjp.v12.i2.298.

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Peter Phiri  1 , Tomas Engelthaler  2 , Hannah Carr  1 , Gayathri Delanerolle  3 , Clive Holmes  4 , Shanaya Rathod  1
Affiliations

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Peter Phiri et al. World J Psychiatry. .

Abstract

Background: Antipsychotic medications such as risperidone, olanzapine and aripiprazole are used to treat psychological and behavioural symptoms among dementia patients. Current evidence indicate prescription rates for antipsychotics vary and wider consensus to evaluate clinical epidemiological outcomes is limited.

Aim: To investigate the potential impact of atypical antipsychotics on the mortality of patients with dementia.

Methods: A retrospective clinical cohort study was developed to review United Kingdom Clinical Record Interactive Search system based data between January 1, 2013 to December 31, 2017. A descriptive statistical method was used to analyse the data. Mini Mental State Examination (MMSE) scores were used to assess the severity and stage of disease progression. A cox proportional hazards model was developed to evaluate the relationship between survival following diagnosis and other variables.

Results: A total of 1692 patients were identified using natural language processing of which, 587 were prescribed olanzapine, quetiapine or risperidone (common group) whilst 893 (control group) were not prescribed any antipsychotics. Patients prescribed olanzapine showed an increased risk of death [hazard ratio (HR) = 1.32; 95% confidence interval (CI): 1.08-1.60; P < 0.01], as did those with risperidone (HR = 1.35; 95%CI: 1.18-1.54; P < 0.001). Patients prescribed quetiapine showed no significant association (HR = 1.09; 95%CI: 0.90-1.34; P = 0.38). Factors associated with a lower risk of death were: High MMSE score at diagnosis (HR = 0.72; 95%CI: 0.62-0.83; P < 0.001), identifying as female (HR = 0.73; 95%CI: 0.64-0.82; P < 0.001), and being of a White-British ethnic group (HR = 0.82; 95%CI: 0.72-0.94; P < 0.01).

Conclusion: A significant mortality risk was identified among those prescribed olanzapine and risperidone which contradicts previous findings although the study designs used were different. Comprehensive research should be conducted to better assess clinical epidemiological outcomes associated with diagnosis and therapies to improve clinical management of these patients.

Keywords: Alzheimer’s disease; Antipsychotics; Dementia; Frontotemporal dementia; Lewy bodies; Mortality; Parkinson’s and mixed; Vascular.

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Conflict of interest statement

Conflict-of-interest statement: Phiri P has received other, educational from Queen Mary University of London, Stanford University School of Medicine and other from John Wiley and Blackwell, outside the submitted work. Rathod S reports other from Janssen, Otsuka and Lundbeck outside the submitted work. All other authors report no conflict of interest.

Figures

Figure 1
Figure 1
Scaled Schoenfeld residuals for age at diagnosis, plotted against time ranks.
See this image and copyright information in PMC

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References

    1. Landi F, Onder G, Cesari M, Barillaro C, Russo A, Bernabei R Silver Network Home Care Study Group. Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci. 2005;60:622–626. - PubMed
    1. Hwang YJ, Dixon SN, Reiss JP, Wald R, Parikh CR, Gandhi S, Shariff SZ, Pannu N, Nash DM, Rehman F, Garg AX. Atypical antipsychotic drugs and the risk for acute kidney injury and other adverse outcomes in older adults: a population-based cohort study. Ann Intern Med. 2014;161:242–248. - PubMed
    1. Fraser LA, Liu K, Naylor KL, Hwang YJ, Dixon SN, Shariff SZ, Garg AX. Falls and fractures with atypical antipsychotic medication use: a population-based cohort study. JAMA Intern Med. 2015;175:450–452. - PubMed
    1. Jeste DV, Maglione JE. Atypical antipsychotics for older adults: are they safe and effective as we once thought? J Comp Eff Res. 2013;2:355–358. - PMC - PubMed
    1. Banerjee S. The use of antipsychotic medication for people with dementia: time for action. A report for the Minister of State for Care Services. [cited 27 May 2021]. Available from: http://psychrights.org/Research/Digest/NLPs/BanerjeeReportOnGeriatricNeu... .