Study Warns Against Antipsychotic Use for Hospitalized Older Adults
Hospitalized older adults who are given antipsychotic drugs for delirium may be at greater risk of death or cardiopulmonary arrest, according to a new study published in the Journal of the American Geriatrics Society.
Delirium — sudden confusion or a rapid change in mental state — affects 15% to 26% of hospitalized older adults. It is particularly problematic because those experiencing the condition may interfere with medical care or directly harm themselves or others.
Besides behavioral therapy and physical restraints, antipsychotic drugs are among the few options healthcare providers can use to ease delirium and protect patients and caregivers; however, these drugs come with risks of their own.
To further investigate the impact of antipsychotic drugs on older hospitalized patients, the researchers looked specifically at death or non-fatal cardiopulmonary arrest (heart attack) at a large academic medical center in Boston.
Previous studies have suggested that typical antipsychotic drugs could cause sudden death, and that atypical antipsychotics could raise peoples’ risks for falls, pneumonia and death. In addition, another large study also suggested that both types of antipsychotic medicines posed a risk for fatal heart attacks.
Still, atypical antipsychotics are commonly prescribed for older hospitalized patients. One recent study of patients at Beth Israel Deaconess Medical Center in Boston found that antipsychotics were prescribed for 9% of all adults who were hospitalized for non-psychiatric causes.
Another large study found that using antipsychotics to prevent or treat delirium did not lower the risk for death, did not lessen the severity of delirium or shorten its duration, and did not shorten the time people spent in the intensive care unit (ICU) or their hospital length of stay.
The new findings show that adults taking “first-generation” or “typical” antipsychotic medications (medicines first developed around the 1950’s) were significantly more likely to experience death or cardiopulmonary arrest, compared to those who did not take these drugs.
Taking “atypical” or “second-generation” antipsychotics (so named because they were developed later) raised the risk for death or cardiopulmonary arrest only for people aged 65 or older.
“Delirium is common in older hospitalized patients and difficult to treat, but antipsychotic medications should be used with caution regardless of age,” said the authors.
Source: American Geriatrics Society
Pedersen, T. (2020). Study Warns Against Antipsychotic Use for Hospitalized Older Adults. Psych Central. Retrieved on September 30, 2020, from https://psychcentral.com/news/2020/01/17/study-warns-against-antipsychotic-use-for-hospitalized-older-adults/153158.html