Heii Arai1, Yu Nakamura2, Masamoto Taguchi3, Hiroyuki Kobayashi4, Keita Yamauchi5, Lon S Schneider6. 1. Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan. Electronic address: heii@juntendo.ac.jp. 2. Department of Psychiatry, Faculty of Medicine, Kagawa University, Kagawa, Japan. 3. Ohgaki Hospital, Gifu, Japan. 4. School of Medicine, Toho University, Tokyo, Japan; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan. 5. Graduate School of Health Management, Keio University, Kanagawa, Japan. 6. Keck School of Medicine, University of Southern California, Los Angeles, USA.
Abstract
INTRODUCTION: We studied the mortality risk of long term and new antipsychotic drug use in Alzheimer's disease (AD) patients in Japan to determine improved treatment protocols. METHODS: This 24-week prospective cohort study included 10,079 Japanese AD patients (female, 69%; average age, 81 years) under routine clinical care in 357 medical sites. The antipsychotic medication history was varied (63.7% were long-term users). Mortality rates and odds ratio were analyzed (initial 10 weeks and from 11-24 weeks). RESULTS: The antipsychotic exposed group with shorter treatment periods had a higher mortality risk compared to controls. The newly prescribed users (antipsychotic treatment started during the follow-up) showed increased mortality (9.4% during the 11-24 week period). CONCLUSIONS: New use of antipsychotic drugs represents a distinct risk for mortality; those on long-term antipsychotic therapy seem to be at less risk. The warning issued 10 years earlier on antipsychotics use for AD patients should be reviewed.
INTRODUCTION: We studied the mortality risk of long term and new antipsychotic drug use in Alzheimer's disease (AD) patients in Japan to determine improved treatment protocols. METHODS: This 24-week prospective cohort study included 10,079 Japanese ADpatients (female, 69%; average age, 81 years) under routine clinical care in 357 medical sites. The antipsychotic medication history was varied (63.7% were long-term users). Mortality rates and odds ratio were analyzed (initial 10 weeks and from 11-24 weeks). RESULTS: The antipsychotic exposed group with shorter treatment periods had a higher mortality risk compared to controls. The newly prescribed users (antipsychotic treatment started during the follow-up) showed increased mortality (9.4% during the 11-24 week period). CONCLUSIONS: New use of antipsychotic drugs represents a distinct risk for mortality; those on long-term antipsychotic therapy seem to be at less risk. The warning issued 10 years earlier on antipsychotics use for ADpatients should be reviewed.