Journal article
Risk of mortality associated with antipsychotic and other neuropsychiatric drugs in pneumonia patients
Journal of clinical psychopharmacology, Vol.26(2), pp.182-187
2006
DOI: 10.1097/01.jcp.0000203598.43314.34
PMID: 16633149
Abstract
Objective: To evaluate the use of typical and atypical antipsychotic medications and associated in-hospital mortality in a group of Veterans Administration (VA) patients with pneumonia.
Method: Our cohort consisted of 14,057 VA patients admitted for pneumonia in fiscal year (FY) 2003. Exposure to typical and atypical antipsychotics and other neuropsychiatric drugs was based on a prescription within 120 days preceding admission. Multivariate models determined the odds of mortality associated with each drug class and risk adjusted for comorbidity, admission source, demographic factors, and concurrent mental health conditions. The referent group for each analysis was pneumonia patients not receiving neuropsychiatric drugs.
Results: In adjusted analyses, the odds of in-hospital mortality for VA patients admitted with pneumonia was higher for recent exposure to typical antipsychotics (OR = 1.51, 95% CI = 1.04-2.19; P = 0.03) when compared to patients not receiving neuropsychiatric medications. Patients exposed to atypical antipsychotics (OR = 1.20, 95% CI = 0.96-1.50, P = .10), tricyclic antidepressants (OR = 1.20, 95% CI = 0.44-1.55; P = 0.15), other antidepressants (OR = 1.07, 95% CI = 0.93-1.23; P = 0.37), or mood stabilizers (OR = 0.91, 95% CI = 0.73-1.14; P = 0.41) had no significant difference in in-hospital mortality.
Conclusion: In spite of recent safety concerns for atypical antipsychotics, we found no increased risk of mortality in acutely ill pneumonia patients. Rather, we found a higher adjusted mortality rate for patients taking typical antipsychotics. The contrasting mortality risks for patients taking typical and atypical antipsychotics may represent unmeasured severity of illness or comorbidity. Regardless, any antipsychotics should be used with caution and the efficacy and safety of alternative agents should be considered.
Details
- Title: Subtitle
- Risk of mortality associated with antipsychotic and other neuropsychiatric drugs in pneumonia patients
- Creators
- Mitchell J BARNETT - The Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Administration Hospital, Iowa City, IA, United StatesPaul J PERRY - University of Iowa College of Pharmacy, Iowa City, IA, United StatesBruce ALEXANDER - The Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Administration Hospital, Iowa City, IA, United StatesPeter J KABOLI - The Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Administration Hospital, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Journal of clinical psychopharmacology, Vol.26(2), pp.182-187
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/01.jcp.0000203598.43314.34
- PMID
- 16633149
- ISSN
- 0271-0749
- eISSN
- 1533-712X
- Language
- English
- Date published
- 2006
- Academic Unit
- Pharmacy; Psychiatry; Epidemiology; Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984094340902771
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