Therapeutics
Review: atypical antipsychotic drugs slightly increase mortality rates in elderly people with dementia
Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294:1934–43.
Q Do atypical antipsychotic drugs increase mortality in people with dementia?
Key Words: antipsychotic drugs • mortality • dementia
| The first 150 words of the full text of this article appear below. |
Design:
Systematic review with meta-analysis.
Data sources:
MEDLINE (1966 to April 2005), Cochrane Controlled Trials Register (2005, issue 1), meeting presentations (1997 to 2004), and information from sponsors.
Study selection and analysis:
Studies were included if they were double blind, randomised, placebo controlled clinical trials of orally administered atypical antipsychotic drugs used to treat Alzheimer’s disease or dementia (vascular dementia, mixed dementia, and primary dementia). Both published and unpublished studies were included. Outcomes were assessed using fixed effect models to calculate odds ratio.
Outcomes:
Deaths occurring during the trial period or within 30 days of discontinuing double blind treatment.
Fifteen trials (nine unpublished) met inclusion criteria. Atypical antipsychotic drugs increased mortality compared with placebo (death: 118/3353 (3.5%) with drugs v 40/1757 (2.3%) with placebo; OR 1.54, 95% CI 1.06 to 2.23). Sensitivity analyses did not show differential risks for individual drugs. Trials were typically 10–12 weeks long (median 10 weeks);
Centro di Medicina dell’Invecchiamento, Dipartimento di Scienze
>Gerontologiche, Geriatriche e Fisiatriche, Università Cattolica del Sacro
>Cuore, Rome, Italy
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