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Starting a conventional antipsychotic increases risk of death more than an atypical antipsychotic in elderly people with dementia

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QUESTION

Question:

Are conventional antipsychotics associated with similar rates of cause specific death as atypical antipsychotics in elderly people with dementia?

People:

37 241 people (⩾65 years) who filled a prescription for an antipsychotic for the first time (index prescription) between 1 January 1996 and 31 December 2004, including 12 882 people starting conventional and 24 359 starting atypical antipsychotics. Data were acquired from a comprehensive healthcare utilisation database that recorded inpatient and outpatient information and pharmacy dispensing for all people coming into contact with the health service during the study period. Exclusion criteria: diagnosis of cancer within 12 months prior to the index prescription; antipsychotic prescription filled within 12 months prior to the index prescription.

Setting:

General population, British Columbia, Canada; 1996 to 2004.

Risk factors:

First time antipsychotic use (conventional or atypical).

Outcomes:

Death within 180 days of starting antipsychotic medication and cause of death (all non-cancer causes; cardiovascular; cardiovascular death outside hospital; infection; respiratory; nervous system; mental …

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