PMID- 24859163
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20220311
IS  - 1179-1942 (Electronic)
IS  - 0114-5916 (Linking)
VI  - 37
IP  - 7
DP  - 2014 Jul
TI  - Are the safety profiles of antipsychotic drugs used in dementia the same? An 
      updated review of observational studies.
PG  - 501-20
LID - 10.1007/s40264-014-0170-y [doi]
AB  - With an increase in the global prevalence of dementia, there is also an increase 
      in behavioural and psychological symptoms of dementia (BPSD) for which 
      antipsychotic drugs are often used. Despite several safety warnings on 
      antipsychotic use in dementia, there is little evidence to support the efficacy 
      of antipsychotics in individual BPSD symptoms or to evaluate the drug safety 
      profile by individual antipsychotic drug. There is emerging but scarce evidence 
      that suggests an inter-drug variability between antipsychotic safety outcomes in 
      BPSD. The objective of this review was to examine the existing literature on 
      antipsychotic drug use in dementia patients; in particular to see whether 
      inter-drug differences regarding antipsychotic safety were reported. A literature 
      search was conducted for observational studies published in the English language 
      from 2004 to 2014 that reported the risk of all-cause mortality, cerebrovascular 
      events, pneumonia and other outcomes such as hip/femur fracture, deep vein 
      thrombosis (DVT) and hyperglycaemia. Six of 16 mortality studies (38%), 7 of 28 
      stroke studies (25%), 1 of 6 pneumonia (17%) studies and 2 of 6 fracture studies 
      (33%) investigated inter-drug safety outcomes in elderly patients/dementia 
      patients, while to our knowledge, there are no studies investigating the 
      inter-drug variation of deep-vein thrombosis and hyperglycaemia risk. The results 
      of the observational studies provide mixed results on the safety of 
      antipsychotics in BPSD but it is clear that there are differences between the 
      safety profiles of antipsychotic drugs. Robust evidence of such inter-drug 
      variability could significantly improve patient safety as antipsychotics become 
      more targeted to clinical risk factors.
FAU - Trifiro, Gianluca
AU  - Trifiro G
AD  - Department of Clinical and Experimental Medicine, Section of Pharmacology, 
      University of Messina, Policlinco Universitario, Via Consolare Valeria, 98125, 
      Messina, Italy, trifirog@unime.it.
FAU - Sultana, Janet
AU  - Sultana J
FAU - Spina, Edoardo
AU  - Spina E
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drug Saf
JT  - Drug safety
JID - 9002928
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Antipsychotic Agents/administration & dosage/*adverse effects/therapeutic use
MH  - Dementia/*drug therapy/mortality/psychology
MH  - Drug Prescriptions/statistics & numerical data
MH  - Drug Utilization Review
MH  - Drug-Related Side Effects and Adverse Reactions/*etiology/mortality
MH  - Humans
MH  - Observational Studies as Topic
EDAT- 2014/05/27 06:00
MHDA- 2015/03/31 06:00
CRDT- 2014/05/27 06:00
PHST- 2014/05/27 06:00 [entrez]
PHST- 2014/05/27 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
AID - 10.1007/s40264-014-0170-y [doi]
PST - ppublish
SO  - Drug Saf. 2014 Jul;37(7):501-20. doi: 10.1007/s40264-014-0170-y.