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Antipsychotic use and unexpected death: a hospital‐based case–control study
Author(s) -
Mace S.,
Dzahini O.,
Cornelius V.,
Anthony D.,
Stewart R.,
Taylor D.
Publication year - 2015
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12507
Subject(s) - medicine , antipsychotic , odds ratio , medical prescription , case control study , disease , psychiatry , emergency medicine , schizophrenia (object oriented programming) , pharmacology
Objective To examine the risk of unexpected death in patients prescribed an antipsychotic. Unexpected death was defined as death occurring within 7 days of the onset of acute symptoms. Method A case–control study conducted on events occurring between July 2009 and January 2011 in a UK mental health trust providing in‐patient and out‐patient services. Results The study included 100 cases (deaths) and 436 unmatched controls. Current users of antipsychotics had a lower risk of unexpected death than non‐users – adjusted odds ratio ( OR ) 0.48 (95% CI 0.24–0.94, P = 0.033). A significant reduction in risk was seen for second‐generation [adjusted OR 0.42 (95% CI 0.21–0.86, P = 0.018)], but not first‐generation agents [adjusted OR 0.83 (95% CI 0.31–2.20, P = 0.706)]. Treatment with antipsychotics for any duration was associated with reduced risk. Dose and route of administration did not affect risk. In a planned secondary analysis not adjusting for cardiovascular disease, prescription of an antipsychotic was not associated with increased risk of unexpected death [adjusted OR 0.56 (95% CI 0.28–1.08, P = 0.084)]. Conclusion Our findings do not support an association between current antipsychotic use and increased risk of unexpected death.