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Patients with Alzheimer Disease on Antipsychotics Show Increased Mortality

Patients with Alzheimer disease who take antipsychotic drugs may be at increased long-term risk for death, according to a study published online in Lancet Neurology.

Some 170 patients with Alzheimer disease who lived in long-term care facilities were randomized to either continue treatment on antipsychotics (most commonly risperidone and haloperidol) or switch to a placebo for 12 months. The group continuing antipsychotics had a significantly lower survival rate over 54 months' follow-up, compared with the placebo group (hazard ratio, 0.58). (In June 2008, the FDA mandated that antipsychotics carry boxed warnings alerting physicians to the mortality risk.)

The authors conclude: "The accumulating safety concerns, including the substantial increase in long-term mortality, emphasize the urgent need to put an end to unnecessary and prolonged prescribing."

An accompanying commentary suggests that if antipsychotics are necessary, they should be given in low doses for short durations, with regular attempts at discontinuation.

LINK(S):

Lancet Neurology article (Free abstract; full text requires subscription)

Lancet Neurology comment (Subscription required)

Physician's First Watch coverage of short-term risks associated with antipsychotics (Free)

Physician's First Watch coverage of FDA adding boxed warnings to conventional antipsychotics (Free)

Published in Physician's First Watch January 9, 2009

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• Sudden Death With Antipsychotics
  Bernard A. Yablin, URMC-Retired, 28 Sep 2009 2:21 PM EST
  Any information pro or com so far with Saphris?