There have been several warnings in recent years that patients with dementia who receive atypical antipsychotics have an increased risk of early mortality. A recent study in BMJ offers more conclusive evidence concerning the risks of certain antipsychotics given to dementia patients.
A study of mortality rates following antipsychotic use in U.S. nursing homes found that haloperidol posed the highest risk when compared with other atypical antipsychotics including risperidone (the one most widely prescribed) and quetiapine. The study, published in BMJ in February, found no clinically meaningful differences in mortality following prescription of aripiprazole, olanzapine, or ziprasidone.
Researchers based their analysis on 11,000 Medicare and Medicaid claims representing first-time users of antipsychotic drugs. All of the patients had begun using the drugs while living in a nursing home during 2001 to 2005. The primary outcome of death within 180 days after the first use of an antipsychotic drug.
In an accompanying editorial, experts said the study "strengthens the argument for avoiding haloperidol." They also noted that quetiapine, the drug associated with lower mortality rates among the atypical, or newer antipsychotics, has not been proven effective in treating neuropsychiatric symptoms in dementia.