INTRODUCTION: 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.
INTRODUCTION: 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: Martha Sajatovic; Laszlo Gyulai; Joseph R Calabrese; Thomas R Thompson; Barbara G Wilson; Robin White; Gary Evoniuk Journal: Am J Geriatr Psychiatry Date: 2005-04 Impact factor: 4.105
Authors: Helen C Kales; Hyungjin Myra Kim; Kara Zivin; Marcia Valenstein; Lisa S Seyfried; Claire Chiang; Francesca Cunningham; Lon S Schneider; Frederic C Blow Journal: Am J Psychiatry Date: 2011-10-31 Impact factor: 18.112
Authors: Philip S Wang; Sebastian Schneeweiss; Jerry Avorn; Michael A Fischer; Helen Mogun; Daniel H Solomon; M Alan Brookhart Journal: N Engl J Med Date: 2005-12-01 Impact factor: 91.245