Use of atypical antipsychotics in the elderly.

Recent research on dementia patients suggests that use of antipsychotics may increase risk of hospitalization or death. While bipolar disorder and schizophrenia combine to represent more than 70 percent of atypical antipsychotic uses in younger patients, these same indications represent only 38 percent of product use in patients age 65 and older. The difference between the two age groups is driven primarily by use in cognitive impairment: Dementia and Alzheimer's combine to account for 28 percent of atypical antipsychotic use in older patients. Although ICD-9 coding tends to group patients into less specific diagnoses, we did isolate a small group of approximately 10 percent of patients that were classified based on the presence or absence of behavior disturbances. Eighteen percent of dementia patients without behavioral disturbances received atypical antipsychotics as compared to 66 percent of patients with behavioral disturbances. A discussion of the results is provided.