Use of antipsychotics in adults with dementia
BMJ 2024; 385 doi: https://doi.org/10.1136/bmj.q819 (Published 17 April 2024) Cite this as: BMJ 2024;385:q819Linked Research
Multiple adverse outcomes associated with antipsychotic use in people with dementia
- Raya Elfadel Kheirbek, professor of medicine 12,
- Cristina LaFon, research coordinator1
- 1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- 2Geriatrics Research, Education and Clinical Center (GRECC), Veterans Affairs Medical Center, Baltimore, MD, USA
- Correspondence to: R E Kheirbek rkheirbek{at}som.umaryland.edu
The linked study by Mok and colleagues (doi:10.1136/bmj-2023-076268) provides new insights into the risks associated with use of antipsychotics in dementia care.1 This population based matched cohort design compared the incidence of serious adverse outcomes, including stroke, venous thromboembolism, myocardial infarction, heart failure, fracture, pneumonia, and acute kidney injury, in adults (≥50 years) with dementia who were prescribed antipsychotics versus those who did not use antipsychotics.
Using data from the Clinical Practice Research Datalink (CPRD) database in England, the study included 35 339 adults with dementia who had just been prescribed antipsychotics for the first time, within a broader population of 173 910 adults with dementia. The authors found significantly increased risks for nearly all evaluated adverse outcomes in antipsychotic users, with especially steep increases for pneumonia (hazard ratio 2.19, 95% confidence interval 2.10 to 2.28), acute kidney injury (1.72, 1.61 to 1.84), …