Atypical Vs Conventional Antipsychotics In The Elderly

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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

• Atypical antipsychotics

• risperidone 75%
• quetiapine 15%
• olanzapine 10%
• clozapine 0.3%

• Conventional antipsychotics:

• loxapine 69%
• haloperidol 11%
• chlorpromazine 7%
• trifluoperazine 5%
• thioridazine 3%
• pimozide 2%
• perphenazine 2%
• others < 1%

• When compared with risperidone, increased mortality ratios found for:

• haloperidol RR= 2.14
• loxapine RR= 1.29

• No increased risk was found when 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

More General Terms

• geriatrics
• clinical trial

References

1. Schneeweiss S et al, Risk of death with use of conventional versus atypical antipsychotic drugs among elderly patients. CMAJ 2007, 176:627 PMID: [1]
2. 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: [2]

atypical vs conventional antipsychotics in the elderly