Mortality in patients with dementia treated with atypical antipsychotics (olanzapine, quetiapine and ziprasidone).
BACKGROUND
The atypical antipsychotics (AA) quetiapine, olanzapine and ziprasidone are used to treat behavioural disorders associated with dementia. This indication does not appear on their technical sheet. The object of this study is to analyse the relationship of these treatments with mortality and other factors.


METHODS
Retrospective study from March 2005 to July 2007 of AA treatments requested as compassionate use. We collected information on mortality, age, history of heart disease or cerebrovascular disease, and duration and number of concomitant treatments per patient.


RESULTS
289 patients were studied. Mortality was 31.1%. A higher mortality rate was shown for patients with a history of heart disease and in those who used olanzapine. Quetiapine was the most commonly prescribed antipsychotic drug.


CONCLUSIONS
The use of AA in the elderly could have risks that outweigh the benefits. When prescribing these drugs for at-risk patients, one should consider their safety warnings and the individual case of each patient. According to our data, olanzapine seems to be associated with a higher risk than quetiapine and ziprasidone.
Martínez Martínez
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L
Servicio de Farmacia, Complexo Hospitalario de Pontevedra, Pontevedra, España. lmarmar1@yahoo.es
Olivera Fernández
M R
MR
Piñeiro Corrales
G
G
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D057176:Compassionate Use Trials; D003704:Dementia / Q000188:drug therapy*; D003987:Dibenzothiazepines / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced* / Q000401:mortality*; D008875:Middle Aged; D000077152:Olanzapine; D010879:Piperazines / Q000009:adverse effects*; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D013844:Thiazoles / Q000009:adverse effects*
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D000077152:Olanzapine