Document Detail

Antipsychotics and Mortality in Parkinsonism.
MedLine Citation:
PMID:  22273735     Owner:  NLM     Status:  Publisher    
BACKGROUND:: The use of antipsychotic medications is associated with an increased risk of death in older adults with dementia. The risk of death in patients with preexisting parkinsonism who receive antipsychotic drugs is not known. METHODS:: Using a nested case-control design, we examined the risk of death within 30 days of newly starting antipsychotic medications among people with Parkinsonism aged 70 years and older in Ontario, Canada. Data were obtained from Ontario's healthcare administrative databases. RESULTS:: Among 5,391 individuals with parkinsonism who died during the study period (2002-2008) and a matched comparison group of 25,937 who were still alive, individuals exposed to atypical antipsychotic drugs had a higher risk of death (unadjusted odds ratio [OR] = 2.8, 95% CI: 2.1-3.8, adjusted OR: 2.0, 95% CI: 1.4-2.7). Results were similar for quetiapine use compared with no antipsychotic use (unadjusted OR: 2.5, 95% CI: 1.6-4.0, adjusted OR = 1.8, 95% CI: 1.1-3.0). Typical antipsychotics were associated with an increased odds of death compared with atypical antipsychotics (unadjusted OR = 2.4, 95% CI 1.1-5.2, adjusted OR = 2.4, 95% CI: 1.1-5.7). CONCLUSIONS:: Individuals with parkinsonism who are newly prescribed antipsychotic medications have a higher risk of death within 30 days than those who do not start these medications. Although it is not possible to establish causality, the results suggest an increased risk. It is important to be vigilant for accompanying serious medical conditions that may increase mortality in individuals requiring treatment with antipsychotics and to consider alternative approaches to treating psychosis, agitation, and aggression in this population.
Connie Marras; Andrea Gruneir; Xuesong Wang; Hadas Fischer; Sudeep S Gill; Nathan Herrmann; Geoffrey M Anderson; Christopher Hyson; Paula A Rochon
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Publication Detail:
Journal Detail:
Title:  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry     Volume:  20     ISSN:  1545-7214     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  149-158     Citation Subset:  -    
From the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital (CM), University of Toronto (CM, GMA, NH, PAR), Women's College Research Institute (AG, PAR), Institute for Clinical Evaluative Sciences (AG, GMA, HF, PAR, XW), Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto (NH); Queen's University, Kingston (SSG); and University of Western Ontario, London (CH), Ontario, Canada.
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