In a new study, researchers suggest cautions about antipsychotic drugs for hospitalized older adults.
The research was conducted by a team at Beth Israel Deaconess Medical Center and elsewhere.
Delirium (sudden confusion or a rapid change in mental state) remains a serious challenge for our health care system.
Delirium affects 15% to 26% of hospitalized older adults and can be 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 therapeutic options healthcare providers can use to ease delirium and protect patients and caregivers—but antipsychotics also come with risks of their own.
Previous studies have suggested that typical antipsychotic medications could cause sudden death, and that atypical antipsychotics could raise peoples’ risks for falls, pneumonia and death.
What’s more, another large study also suggested that both types of antipsychotic medicines posed a risk for fatal heart attacks.
Despite these known risks, atypical antipsychotics are often prescribed for people in the hospital.
In the current study, the research team analyzed information from hospitalized patients at a large academic medical center in Boston.
They looked specifically at death or non-fatal cardiopulmonary arrest (heart attack) during hospitalization.
They found that adults taking “first-generation” or “typical” antipsychotic medications (medicines first developed around the 1950s) were much more likely to experience death or cardiopulmonary arrest, compared to people who did not take those drugs.
Taking “atypical” or “second-generation” antipsychotics (so named because they were developed later) raised the risk for death or cardiopulmonary arrest for people aged 65 or older.
The team says delirium is common in older hospitalized patients and difficult to treat, but antipsychotic drugs should be used with caution regardless of age.
The lead author of the study is Matthew Basciotta, M.D., Beth Israel Deaconess Medical Center.
The study is published in the Journal of the American Geriatrics Society.
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