Risk of Death with Atypical Antipsychotic Medications for Dementia

2018 ◽  
Author(s):  
Adam P. Mecca ◽  
Rajesh R. Tampi
Keyword(s):  
Side Effects ◽  
Atypical Antipsychotic ◽  
Odds Ratio ◽  
Clinical Case ◽  
Atypical Antipsychotics ◽  
Meta Analysis ◽  
Antipsychotic Medications ◽  
Risk Of Death ◽  
Increased Risk ◽  
Atypical Antipsychotic Medications

This chapter provides a summary of a landmark meta-analysis that investigated the risks of atypical antipsychotic use to treat psychosis, aggression, or agitation in patients with dementia. The chapter briefly reviews the study design, as well as implications and limitations. A relevant clinical case concludes the chapter. In summary, atypical antipsychotic use for 6 to 26 weeks was associated with increased risk of death (Odds Ratio of 1.54 for antipsychotic vs placebo). There were no differences in risk between individual medications, disease severity, indication for antipsychotic, or treatment setting. In patients with psychosis, agitation, or aggression due to dementia, the efficacy of atypical antipsychotics is questionable and their use comes with considerable risks of side effects and adverse events.

Risk of Death in Elderly Users of Conventional vs. Atypical Antipsychotic Medications

2005 ◽  
Vol 353 (22) ◽  
pp. 2335-2341 ◽  
Author(s):  
Philip S. Wang ◽  
Sebastian Schneeweiss ◽  
Jerry Avorn ◽  
Michael A. Fischer ◽  
Helen Mogun ◽  
...  
Keyword(s):  
Atypical Antipsychotic ◽  
Antipsychotic Medications ◽  
Risk Of Death ◽  
Atypical Antipsychotic Medications ◽  
Elderly Users

scholarly journals Dietary fiber and probiotics for the treatment of atypical antipsychotic-induced metabolic side effects: study protocol for a randomized, double-blind, placebo-controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chenchen Liu ◽  
Dongyu Kang ◽  
Jingmei Xiao ◽  
Yuyan Huang ◽  
Xingjie Peng ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Weight Gain ◽  
Side Effects ◽  
Dietary Fiber ◽  
Atypical Antipsychotic ◽  
Double Blind ◽  
Antipsychotic Medications ◽  
Double Blind Placebo ◽  
Metabolic Side Effects ◽  
Atypical Antipsychotic Medications

Abstract Background Atypical antipsychotic medications, which are effective for the treatment of schizophrenia and bipolar disorder, are associated with features of metabolic syndrome, such as weight gain, hyperglycemia, dyslipidemia, and insulin resistance. Although there are a few studies on the effects of dietary fiber or probiotics on weight loss in obese people, no published trials have reported the efficacy of dietary fiber and probiotics on reducing atypical antipsychotic-induced weight gain. Methods For this 12-week randomized, double-blind, placebo-controlled study, 100 patients with a weight gain of more than 10% after taking atypical antipsychotic medications were recruited. Participants were randomized to four groups as follows: probiotics (840 mg twice daily (bid)) plus dietary fiber (30 g bid), probiotics (840 mg bid) plus placebo, placebo plus dietary fiber (30 g bid), or placebo group. The primary outcome was the change in body weight. Secondary outcomes included changes in metabolic syndrome parameters, appetite score, biomarkers associated with a change in weight, and gut microbiota composition and function. Discussion To date, this is the first randomized, placebo-controlled, double-blinded trial investigating the efficacy of dietary fiber and probiotics alone and in combination to reduce metabolic side effects induced by atypical antipsychotic medications. If effective, it is possible to conclude that dietary fiber and probiotics can reduce atypical antipsychotic-induced metabolic side effects. Trial registration number ClinicalTrials.gov NCT03379597. Registered on 19 November 2017.

Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer’s Disease

2018 ◽  
Author(s):  
Adam P. Mecca ◽  
Rajesh R. Tampi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Adverse Events ◽  
Atypical Antipsychotic ◽  
Clinical Case ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Multicenter Trial ◽  
Antipsychotic Treatment

This chapter provides a summary of the Clinical Antipsychotic Trials of Intervention Effectiveness—Alzheimer’s disease (CATIE-AD), a multicenter trial that investigated whether atypical antipsychotics are an effective treatment for psychosis, aggression, or agitation in outpatients with Alzheimer’s disease. The chapter briefly reviews the study design, as well as implications and limitations. A relevant clinical case concludes the chapter. In summary, atypical antipsychotic use for up to 36 weeks did not lead to clinical improvement based on time to discontinuation, or symptom reduction. Risk of discontinuation due to adverse events and side-effects with worse with antipsychotic treatment compared to placebo. In patients with psychosis, agitation, or aggression due to Alzheimer’s disease, the efficacy of atypical antipsychotics is questionable and their use comes with considerable risks of side effects and adverse events.

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