February 27, 2012
Antipsychotic Medication Death Rate Among Dementia Patients Analyzed
A new Harvard Medical School (HMS) and Brigham and Women's Hospital study has discovered that some types of antipsychotic medication present more of a risk of death in older dementia patients than others.
According to MedPage Today North American Correspondent Michael Smith, Dr. Krista Huybrechts of the Boston hospital and colleagues looked at six medications used to treat dementia in more than 75,000 nursing home residents over the age of 65 who had started using the drugs between 2001 and 2005. They measured mortality rates for all potential causes of death except cancer that occurred within the first six months of using the drug.
The experts used risperidone (Risperdal) as the baseline medication as it was the most commonly used, and compared it to five other drugs -- haloperidol, quetiapine, aripiprazole (Abilify), olanzapine (Zyprexa), and ziprasidone (Geodon, Zeldox) -- Smith wrote on Thursday.
They discovered that the potential for fatality with haloperidol was double that of risperidone, making it the most dangerous. In fact, Huybrechts told Smith that the use of haloperidol to treat this condition "cannot be justified because of the excess harm,"
Quetiapine was the only one of the other five to have a lesser risk of death, and the other three were "not significantly different" than risperidone, and other types of antipsychotics "were excluded because they collectively formed less than 1% of prescriptions," according to MedPage.
However, as BBC News Health and Science Reporter James Gallagher points out, the methodology of the study does not prove that one medication actually resulted in more deaths than another. Rather, the study merely establishes a correlation between the drugs and the respective death rates.
The UK Department of Health told Gallagher that use of antipsychotics to treat dementia results in up to 1,800 deaths per year -- a figure that they call "simply unacceptable."
They are looking to cut prescriptions of these medications for dementia patients by two-thirds, but the Dementia Action Alliance -- a coalition made up of the Alzheimer's Society, Age UK and the Department of Health -- is calling for all such prescriptions to be reviewed by the end of March, according to the BBC.
"This study provides an interesting insight into the differential harm of these medicines," Dr. Chris Fox, a dementia researcher at the University of East Anglia, told Gallagher, adding that "more work is needed on alternatives to these medicines in dementia with behavioral problems“¦ In addition, there is a need to consider duration of use in more acute situations such as severe distress. Is six or 12-week use safe in people with dementia?"
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