Cardiac and cerebrovascular morbidity and mortality associated with antipsychotic medications in elderly psychiatric inpatients.
OBJECTIVE
To evaluate the rate of adverse medical outcomes for elderly exposed to antipsychotic treatment.


METHODS
This was a retrospective evaluation of psychiatric inpatients records. Age, gender, diagnosis, treatment with antipsychotics, and duration of treatment were analyzed. An acute cardiac or cerebrovascular event necessitating transfer to a general hospital or resulting in death was the outcome measure.


RESULTS
During 15 years (1990 to 2005), 3,111 elderly were hospitalized. Their mean age was 73.5 +/- 6.1 years, 1,220 were male (39%), and 1,891 were female (61%). Most patients (2,583 [83%]) were exposed to antipsychotics, of which 1,402 (54%) were exposed to second-generation antipsychotics (SGAs). Antipsychotic-treated patients did not have a higher rate of adverse medical outcomes compared with patients who had not received antipsychotics. No significant differences were noted between patients exposed to typical antipsychotics or SGAs.


CONCLUSIONS
Treatment of elderly psychiatric inpatients with antipsychotics did not increase their risk of adverse medical outcomes. Thus, regulating the use of conventional antipsychotics or SGAs for all elderly patients in all indications may be premature.
Barak
Yoram
Y
Abarbanel Mental Health Center, Bat-Yam, Israel. mdybarak@netvision.net.il
Baruch
Yehuda
Y
Mazeh
Doron
D
Paleacu
Diana
D
Aizenberg
Dov
D
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000401:mortality*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002423:Cause of Death; D002544:Cerebral Infarction / Q000139:chemically induced* / Q000401:mortality*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000401:mortality*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors
D014150:Antipsychotic Agents