Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients

Kleijer, Bart C.; Heerdink, Eibert R.; Egberts, Toine C. G.; Jansen, Paul A. F.; Marum, Rob J. van

doi:10.1097/jcp.0b013e3181f0e87d

Cited by 35 publications

(34 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Especially, the use of antipsychotic drugs in patients with dementia has been shown to increase the risk of death, 13,14 stroke, 15,16 and cardiac arrhythmias 17 although this is not confirmed in a more recent meta-analysis including randomized controlled trials. 18 A recent Norwegian study in nursing home patients did not show an association of PDU with long-term mortality risk.…”

mentioning

confidence: 97%

Prevalence and correlates of psychotropic drug use in Dutch nursing home patients with young‐onset dementia

Mulders

Zuidema

Leeuwis

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives Neuropsychiatric symptoms (NPSs) in dementia patients in nursing homes are common and often treated with psychotropic drugs. Thus far, studies on psychotropic drug use (PDU) mainly focused on elderly patients with dementia. It is important to know the prevalence and correlates of PDU in patients with young‐onset dementia (YOD) to optimize NPS treatment and reduce excess PDU in this group. Design The Behavior and Evolution in Young‐Onset Dementia (BEYOnD) study is a cross‐sectional study in 230 residents with YOD in eight nursing homes providing specialized YOD care. PDU was registered from medical charts. The influence of age, gender, severity, and type of dementia, NPS, and agitation on PDU was analyzed. Results Eighty‐seven percent of the residents used psychotropic drugs, and 47% used two or more psychotropic drugs. No significant associations with age, gender, dementia subtype, and dementia severity were found. Depressive symptoms showed an association with the use of antidepressants, nighttime behavior with use of hypnotics, and verbal agitation with antipsychotics. Apathy was strongly associated with lower PDU. Conclusions Nursing home patients with YOD have a high prevalence of PDU. The association with NPS raises questions of efficacy of these drugs in managing NPS. Patients with apathy had a lower chance of using psychotropics. More research on indications and effects of psychotropic drugs is needed, as well as on (nonpharmacological) alternatives for managing challenging behavior in YOD.

show abstract

mentioning

confidence: 97%

Prevalence and correlates of psychotropic drug use in Dutch nursing home patients with young‐onset dementia

Mulders

Zuidema

Leeuwis

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

“…However, previous studies did not suggest that the risk of VTE increases with higher doses of APDs. 32,42 In conclusion, our study suggests an increased risk of VTE for elderly users of APDs with dementia, especially within 90 days after initiation of APD use and for the combination of SADs and FADs. Clinicians should pay particular attention to clinical signs of VTE during the first 3 months of treatment with antipsychotics and in patients receiving both conventional and atypical agents, especially if further risk factors such as hip fractures or previous VTE exist.…”

Section: Discussionmentioning

confidence: 89%

Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients With Dementia

Schmedt

Garbe²

2013

Journal of Clinical Psychopharmacology

View full text Add to dashboard Cite

The aim of this study was to investigate the association between the use of antipsychotics and the risk of venous thromboembolism (VTE) in elderly patients with dementia. Based on data from the German Pharmacoepidemiological Research Database, a nested case-control study was conducted within a cohort of 72,591 patients with dementia aged at least 65 years at cohort entry. Cases were patients with a hospitalization due to VTE. Up to 4 controls were matched to each case according to age, sex, health insurance, and calendar time of the VTE. Users of antipsychotics were classified into current or former users, and in addition, all current users were categorized as prevalent or new users. For a further analysis, we distinguished between users of either conventional or atypical antipsychotics or concurrent users of both conventional and atypical antipsychotics. Multivariate conditional logistic regression was applied to calculate odds ratios (ORs) of VTE for all user groups compared with nonusers. The case-control data set comprised 1028 VTE cases and 4109 controls. An increased risk of VTE was found for current users (OR, 1.23; 95% confidence interval [CI], 1.01-1.50) and for users of a combination of atypical and conventional antipsychotics (OR, 1.62; 95% CI, 1.15-2.27). In current users, only new use was associated with an increased risk (OR, 1.63; 95% CI, 1.10-2.40). Increased attention to clinical signs of VTE should be paid during the first 3 months of treatment with antipsychotics and in patients receiving both conventional and atypical agents, especially if other risk factors for VTE exist.

show abstract

“…The risk of pneumonia is higher in patients treated with antipsychotics, probably due to their anticholinergic and H 1 receptor blocking actions, possibly causing swallowing problems and aspiration pneumonia 69. Deep venous thrombosis has also been described in patients taking both conventional and atypical antipsychotics 70,71…”

Section: Resultsmentioning

confidence: 99%

Use of atypical antipsychotics in the elderly: a clinical review

Gareri¹,

Segura-Garcìa²,

Manfredi³

et al. 2014

CIA

View full text Add to dashboard Cite

The use of atypical antipsychotic drugs in the elderly has become wider and wider in recent years; in fact, these agents have novel receptor binding profiles, good efficacy with regard to negative symptoms, and reduced extrapyramidal symptoms. However, in recent years, the use of both conventional and atypical antipsychotics has been widely debated for concerns about their safety in elderly patients affected with dementia and the possible risks for stroke and sudden death. A MEDLINE search was made using the words elderly, atypical antipsychotics, use, schizophrenia, psychosis, mood disorders, dementia, behavioral disorders, and adverse events. Some personal studies were also considered. This paper reports the receptor binding profiles and the main mechanism of action of these drugs, together with their main use in psychiatry and the possible adverse events in elderly people.

show abstract

Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients

Abstract: We found no evidence of an increased risk of VTE in elderly patients using antipsychotic drugs.

Cited by 35 publications

References 21 publications

Prevalence and correlates of psychotropic drug use in Dutch nursing home patients with young‐onset dementia

Prevalence and correlates of psychotropic drug use in Dutch nursing home patients with young‐onset dementia

Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients With Dementia

Use of atypical antipsychotics in the elderly: a clinical review

Contact Info

Product

Resources

About