Data di Pubblicazione:
2009
Abstract:
Purpose: To compare the safety of conventional and nonconventional
antipsychotics in older persons. Specific aims included
to i) compare the risk of all-cause mortality among users of
conventional versus atypical antipsychotic drugs, ii) investigate
whether any increased mortality risk was limited to specific causes
of death, and was still present after adjusting for comorbidities and,
iii) examine mortality risks among users of conventional versus
atypical antipsychotic in people with Alzheimer's Disease (AD).
Method: The study included a retrospective cohort study of
residents in Milan, Italy, aged 60+ who were prescribed an
antipsychotic drug for the first time during April 1, 2002 to
June 15, 2005. Data were obtained from the health authorities'
information systems. 7739 persons using antipsychotic drugs
(n = 2908 conventional, n = 4831 atypical) were included. Overall
and cause-specific mortality over six months following first
prescription of an antipsychotic drug was investigated. Covariates
included, age, sex, and comorbities (cancer, cardio/cerebrovascular
and other diseases). Mortality was assessed both in the whole
cohort, and a subset of people with AD who were prescribed
cholinesterase inhibitors.
Results: People prescribed atypical antipsychotics had 65% lower
all-cause mortality (HR 0.35, 95% CI 0.31-0.39) than those
prescribed conventional antipsychotics. This mortality risk was
explained by cancer deaths, with no differences within deaths for
other conditions. Among people using cholinesterase inhibitors,
no statistically significant difference in mortality was observed for
users of conventional versus atypical antipsychotics.
Conclusion: The characteristics of the observed differences in
mortality suggest that there might be a preferential prescription
of conventional drugs in terminally ill cancer patients. There is no
evidence of a differential survival in AD patients using conventional
or atypical antipsychotics.
antipsychotics in older persons. Specific aims included
to i) compare the risk of all-cause mortality among users of
conventional versus atypical antipsychotic drugs, ii) investigate
whether any increased mortality risk was limited to specific causes
of death, and was still present after adjusting for comorbidities and,
iii) examine mortality risks among users of conventional versus
atypical antipsychotic in people with Alzheimer's Disease (AD).
Method: The study included a retrospective cohort study of
residents in Milan, Italy, aged 60+ who were prescribed an
antipsychotic drug for the first time during April 1, 2002 to
June 15, 2005. Data were obtained from the health authorities'
information systems. 7739 persons using antipsychotic drugs
(n = 2908 conventional, n = 4831 atypical) were included. Overall
and cause-specific mortality over six months following first
prescription of an antipsychotic drug was investigated. Covariates
included, age, sex, and comorbities (cancer, cardio/cerebrovascular
and other diseases). Mortality was assessed both in the whole
cohort, and a subset of people with AD who were prescribed
cholinesterase inhibitors.
Results: People prescribed atypical antipsychotics had 65% lower
all-cause mortality (HR 0.35, 95% CI 0.31-0.39) than those
prescribed conventional antipsychotics. This mortality risk was
explained by cancer deaths, with no differences within deaths for
other conditions. Among people using cholinesterase inhibitors,
no statistically significant difference in mortality was observed for
users of conventional versus atypical antipsychotics.
Conclusion: The characteristics of the observed differences in
mortality suggest that there might be a preferential prescription
of conventional drugs in terminally ill cancer patients. There is no
evidence of a differential survival in AD patients using conventional
or atypical antipsychotics.
Tipologia CRIS:
04.02 Abstract in Atti di convegno
Keywords:
antipsychotic drugs; mortality; AD
Elenco autori:
Adorni, FULVIO DANIELE; Musicco, Massimo
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