Certain Antipsychotics Increase Risk Of Mortality In Elderly Patients

Healthcare providers around the world use “first generation” antipsychotic drugs to treat delirium. This syndrome is defined as a loss of contact with reality, most often accompanied by delusional thoughts and beliefs in false and / or irrational beliefs. A new study, conducted at Beth Israel Deaconess Medical Center in Boston (United States) and published in the Journal of the American Geriatrics Society, advises caution when prescribing these drugs, which would increase the risk of mortality in the elderly.

According to statistics, in the United States, delusional disorders affect 15 to 26% of elderly people hospitalized. If this disease becomes a matter of concern, it is because a person in this situation acts in a particularly problematic manner and can interfere with medical care, harm themselves or even other people.

Increased risk of death and cardiopulmonary arrest

In addition to behavioral therapy and physical restraint, doctors around the world are prescribing antipsychotics to relieve delirium and protect patients and caregivers. A study by a research team at the Boston Medical Center shows that the prescription of such drugs can lead to death or non-fatal cardiopulmonary arrest (heart attack) during hospitalization.

For their study, the researchers compiled all the hospitalizations that occurred at the Boston medical center between 2010 and 2016. People admitted to the intensive care unit, and to the gynecology, obstetrics and psychiatry departments, or having been diagnosed with a disorder psychotic, were not retained. In total, they looked at more than 150,000 hospitalizations.

Caution

Among all these people, 691 of them died or suffered a cardiopulmonary arrest (515 dead and 176 cardiopulmonary arrests). Looking at the results, the team discovered that the use of so-called “first generation” antipsychotic drugs (developed around the 1950s) increased the risk of death and cardiopulmonary arrest. However, taking “second generation” antipsychotics (so called because they were developed later) increased the risk of death or cardiopulmonary arrest only in people 65 years of age or older.

The study also points out that in the United States, 9% of adults hospitalized for non-psychiatric causes were still prescribed antipsychotics. A previous study by the Beth Israel Deaconess Medical Center had previously found that the administration of antipsychotics had no effect on the severity of the delirium or reduced the duration, nor did it decrease the time spent in an intensive care unit or hospital. As with the previous study, therefore, the authors recommend that healthcare teams exercise caution when prescribing antipsychotics for people with delirium, especially if they are elderly.

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