|Titre :||Risk of death in elderly users of conventional vs. atypical antipsychotic medications (2005)|
|Auteurs :||P. S. WANG ; SCHNEEWEISS S. ; J. AVORN ; M. A. FISCHER ; MOGUN H. ; SOLOMON D. H. ; BROOKHART M. A.|
|Type de document :||Article : Périodique|
|Dans :||New England Journal of Medicine (Vol.353, n°22, December 1, 2005)|
|Article en page(s) :||2335-2341|
Thésaurus TOXIBASEPERSONNE AGEE ; TROUBLE BIPOLAIRE ; MORTALITE ; FACTEUR DE RISQUE ; MEDICAMENTS ; PSYCHOSE ; ENQUETE ; ETUDE LONGITUDINALE ; PSYCHOTROPES ; MORT
Background: Recently, the Food and Drug Administration (FDA) issued an advisory stating that atypical antipsychotic medications increase mortality among elderly patients. However, the advisory did not apply to conventional antipsychotic medications; the risk of death with these older agents is not known.
Methods: We conducted a retrospective cohort study involving 22,890 patients 65 years of age or older who had drug insurance benefits in Pennsylvania and who began receiving a conventional or atypical antipsychotic medication between 1994 and 2003. Analyses of mortality rates and Cox proportional-hazards models were used to compare the risk of death within 180 days, less than 40 days, 40 to 79 days, and 80 to 180 days after the initiation of therapy with an antipsychotic medication. We controlled for potential confounding variables with the use of traditional multivariate Cox models, propensity-score adjustments, and an instrumental-variable analysis.
Results: Conventional antipsychotic medications were associated with a significantly higher adjusted risk of death than were atypical antipsychotic medications at all intervals studied ( Conclusions: If confirmed, these results suggest that conventional antipsychotic medications are at least as likely as atypical agents to increase the risk of death among elderly persons and that conventional drugs should not be used to replace atypical agents discontinued in response to the FDA warning.
|Domaine :||Autres substances / Other substances|
|Refs biblio. :||29|
|Affiliation :||Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA, USA|
|Centre Emetteur :||13 OFDT|