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Current use of second-generation antipsychotics may increase risk of pneumonia in people with schizophrenia

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Question: Do second-generation antipsychotics increase the risk of pneumonia in people with schizophrenia?

People: 33 024 adults with schizophrenia (aged 18–65 years) identified from a national cohort of 187 117 people hospitalised with any mental illness over a 12-year period (1996–2008). Inclusion criteria: psychiatric admission at least once during the study period, but not in the preceding 4 years (1996–1999); principle diagnosis of schizophrenia at discharge (ICD-9). Cases were people hospitalised for pneumonia following first psychiatric admission (n=1739). Date of hospitalisation was the index date. At least four age-matched and gender-matched controls were randomly selected who had not been hospitalised with pneumonia (n=6949).

Setting: National Health Insurance Research Database, Taiwan; recruitment 2000–2008.

Risk factors: Exposure to second-generation antipsychotics. Prescription files were used to calculate the total number of prescriptions and the dosing regimen. The drug use was defined as current if the prescription was within 30 days of the index date. Recent drug use was between 31 and 180 days of the index date, and past drug use more than 180 days before. Amisulpride, clozapine, …

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