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atypical vs conventional antipsychotics in the elderly
Clinical trials:
[1]
British Columbia residents >= 65 years of age
1st oral antipsychotic treatment 1996-2004
Study outcome death from any cause
Results:
- within the 1st 180 days, 14.1% of conventional antipsycotic users died vs 9.6% of atypical antipsychotic users
- when compared with risperidone, increased mortality ratios found for:
- haloperidol RR= 2.14
- loxapine RR= 1.29
- no increased risk was found when risperidone was compared with olanzapine
[2]
Veterans Affairs retrospective study of 10,615 veterans who began psychiatric medication following a dementia diagnosis.
One-year mortality
- 25% in users of conventional antipsychotics
- 23% in users of atypical antipsychotics
- 15% in users of other psychiatric drugs
- 18% in non-users of psychiatric medication
* antidepressants & anxiolytics/hypnotics
General
clinical trial
References
- Schneeweiss S et al,
Risk of death with use of conventional versus atypical
antipsychotic drugs among elderly patients.
CMAJ 2007, 176:627
PMID: 17325327
- Kales HC, Valenstein M, Kim HM, McCarthy JF, Ganoczy D,
Cunningham F, Blow FC.
Mortality risk in patients with dementia treated with
antipsychotics versus other psychiatric medications.
Am J Psychiatry. 2007 Oct;164(10):1568-76.
PMID: 17898349
- Meltzer HY
Update on typical and atypical antipsychotic drugs.
Annu Rev Med. 2013;64:393-406. Epub 2012 Sep 27. Review.
PMID: 23020880