1. Increased All-Cause Mortality by Antipsychotic Drugs: Updated Review and Meta-Analysis in Dementia and General Mental Health Care
- Author
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Stephen John Ralph and Anthony J. Espinet
- Subjects
medicine.medical_specialty ,Deprescriptions ,Antipsychotic agents ,medicine.medical_treatment ,health care reform ,review ,causes of death ,clinical governance ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Dementia ,030212 general & internal medicine ,Adverse effect ,Intensive care medicine ,Antipsychotic ,risk ,deprescriptions ,business.industry ,General Neuroscience ,Retrospective cohort study ,medicine.disease ,Mental health ,psychotropic drugs ,excess mortality ,meta-analysis ,Psychiatry and Mental health ,Clinical Psychology ,Meta-analysis ,Health care reform ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Research Article ,dementia - Abstract
It is almost ten years since the Banerjee 2009 report established that inappropriate prescribing of antipsychotics in the elderly was occurring in the UK and such patients had an 85% increased risk of adverse events and greater mortality. This report was a critical analysis addressing the outcomes of treatment practices for dementia in UK patients and globally, aimed at reducing prescribing of antipsychotic drugs for dementia. Since 2009, many significant studies worldwide (including several more recent large retrospective studies) provide more extensive longitudinal data for the adverse impacts of antipsychotic drugs in dementia. We have used the data in these studies including from over 380,000 dementia patients, with 85,069 prescribed antipsychotic agents as well as from 359,235 non-dementia antipsychotic drug users to provide an up-dated meta-analysis. This is the first meta-analysis to include evidence from general mental health studies showing that antipsychotic drugs precipitate excessive mortality across the spectrum. Prescribing of antipsychotic drugs for dementia or for other mental health care should be avoided and alternative means sought for handling behavioral disorders of such patients.
- Published
- 2018
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