Antipsychotics may hasten death in those with dementia

Drugs prescribed to address behavioral issues in older adults with dementia may hasten their deaths more than previously realized, according to a new study published in JAMA Psychiatry. The research adds more evidence to the argument against using antipsychotic drugs to treat delusions, hallucinations, agitation and aggression that many people with Alzheimer’s disease and other dementias experience.

“The harms associated with using these drugs in dementia patients are clear, yet clinicians continue to use them,” lead author and psychiatrist Donovan Maust, MD, MS, said in a statement. “That’s likely because the symptoms are so distressing. These results should raise the threshold for prescribing further.”

In the new retrospective, case-controlled study, researchers from the University of Michigan, the Veterans Affairs Ann Arbor Healthcare System and the University of Southern California looked at the medical records of more than 90,000 American veterans with dementia who were aged more than 65 years. Data from each individual who took a psychiatric medication were matched to data from a similar person who did not take drugs to calm their behavior. The investigators found that those taking antipsychotics had outsized risks of death. Among those taking the newer, more commonly used antipsychotics, the risk climbed along with the dose.

The study also examined other psychiatric medications. The risk of death seen with the mood stabilizer valproic acid was similar to that seen with antipsychotics. Antidepressants had less risk compared with antipsychotics and valproic acid, but the risk was still higher than that seen with people not taking any psychiatric medications to treat behavior issues in dementia.

The study was funded by the National Institute of Mental Health and the National Institute on Aging of the National Institutes of Health.

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