title: Mortality risk with the use of atypical antipsychotics in later-life bipolar disorder.
abstract: BACKGROUND
  In recent years, concerns about the use of antipsychotic medications in dementia have grown. There is limited data on mortality risk of atypical antipsychotics for other psychiatric disorders of later life such as bipolar disorder.
  
  
  METHODS
  Data were derived from the national Department of Veterans Affairs registries for older patients with bipolar disorder (≥65 years) with a new start of an atypical antipsychotic (risperidone, olanzapine, or quetiapine) or valproic acid and derivatives during fiscal years 2001-2008. Six-month mortality rates were compared for individual drug groups.
  
  
  RESULTS
  The sample included 4717 patients. The risperidone cohort had the highest mortality rate (11.8 per 100 person-years) with the quetiapine and valproic acid cohorts having the lowest (5.3 and 4.6 per 100 person-years, respectively). Various methods to adjust for baseline differences including propensity models showed similar patterns.
  
  
  CONCLUSIONS
  Among older patients with bipolar disorder, there may be differences in mortality risks among individual antipsychotic agents.
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Bhalerao
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Seyfried
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: Claire
authors.initials: C
authors.lastname: Chiang
authors.forename: Janet
authors.initials: J
authors.lastname: Kavanagh
authors.forename: Helen C
authors.initials: HC
authors.lastname: Kales
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000401:mortality; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000077152:Olanzapine; D016016:Proportional Hazards Models; D000069348:Quetiapine Fumarate; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D014635:Valproic Acid; D018967:Risperidone; D000077152:Olanzapine