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Cumulative dosages of antipsychotic drugs are associated with increased mortality rate in patients with Alzheimer's dementia
Author(s) -
Nielsen R. E.,
Lolk A.,
Valentin J. B.,
Andersen K.
Publication year - 2016
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.12614
Subject(s) - dementia , medicine , antipsychotic , cohort , dose , retrospective cohort study , population , cohort study , psychiatry , schizophrenia (object oriented programming) , disease , environmental health
Objective We wished to investigate the effects of cumulative dosages of antipsychotic drug in Alzheimer′s dementia, when controlling for known risk factors, including current antipsychotic exposure, on all‐cause mortality. Method We utilized a nationwide, population‐based, retrospective cohort study design with mortality as outcome in individual patients diagnosed with Alzheimer′s dementia. Results We included a total of 45 894 patients and followed them for 3 803 996 person‐years in total, presenting 27 894 deaths in the study population. Cumulative antipsychotic exposure increased mortality: more than 0 Daily Defined Dosage (DDDs) but less than 90: HR 2.20, 95% CI (2.14–2.27), P < 0.001; more than or equal to 90 DDD s but less than 365: HR 1.81, 95% CI (1.74–1.89), P < 0.001; more than or equal to 365 DDD s but less than 730: HR 1.38, 95% CI (1.428–1.49), P < 0.001; and more than or equal to 730 DDD s: HR 1.06, 95% CI (0.95–1.18), P = 0.322, when controlling for proxy markers of severity, somatic and mental comorbid disorders. Conclusion In this nationwide cohort study of 45 894 patients diagnosed with Alzheimer′s dementia, we found that cumulative dosages of antipsychotic drugs were associated with increased mortality rates.