Certain Antipsychotics Up Risk of Death for Patients With
THURSDAY, Feb. 23 (HealthDay News) Compared to other
antipsychotic drugs, haloperidol (Haldol) raises the risk of death
in elderly patients with dementia, a new study finds.
One outside expert believes the finding should aid in dementia
care. "This data provides much-needed guidance and reassurance for
the ever-increasing number of health care practitioners treating
older demented patients," said Dr. Gisele Wolf-Klein, director of
geriatric education at the North Shore-LIJ Health System in New
Hyde Park, N.Y.
The study was published online Feb. 23 in the
British Medical Journal.
In 2005, the U.S. Food and Drug Administration warned that
certain antipsychotic drugs are associated with an increased risk
of death in elderly patients with dementia. This warning was
expanded to include conventional antipsychotics in 2008, according
to a journal news release.
The authors of the new study said that, despite the FDA action,
the use of antipsychotic drugs for this patient population is
likely to grow. According to the Harvard Medical School
researchers, that's because there are a growing number of elderly
patients with dementia who require some type of treatment.
Wolf-Klein agreed, noting that safety concerns over the use of
antipsychotics are "leaving primary care physicians, geriatricians,
neurologist and psychiatrists in a quandary as they attempt to
respond to overwhelmed caregivers dealing with unmanageable
behaviors at home. Discussion with family members of the risks and
benefits of atypical antipsychotics creates additional stress and
burden in an already difficult situation."
In the study, the Harvard group examined 2001-2005 data from
more than 75,000 nursing home residents, aged 65 and older, in
facilities across 45 states. They sought to assess the risk of
death associated with widely used antipsychotic drugs such as
aripiprazole, haloperidol, olanzapine, quetiapine, risperidone and
During the six-month study period, about 6,600 of the nursing
home residents died from causes that were unrelated to cancer.
Those who took haloperidol had double the risk of death compared to
those who took risperidone, while those who took quetiapine
(Seroquel) had a lower risk of death.
The researchers found that the effect of haloperidol was
strongest during the first 40 days of treatment and that this did
not change after doses were adjusted. Circulatory disorders
accounted for 49 percent the deaths, respiratory disorders for 15
percent and brain disorders for 10 percent.
Not all antipsychotic medications carry the same risk of death
in elderly patients and doctors "may want to consider this evidence
when evaluating ... the best approach to treatment of behavioral
problems," the researchers wrote.
Wolf-Klein said the study offers doctors valuable guidance going
forward, and she called it "a landmark approach to addressing the
pressing clinical need of practicing physicians confronted with
behavioral issues in elderly demented patients."
The American Academy of Family Physicians has more about
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