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Atypical antipsychotics and parkinsonism
Paula A Rochon1, Therese A Stukel, Kathy Sykora
1Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. paula.rochon@utoronto.ca
Archives of Internal Medicine
|September 15, 2005
Summary
Older adults taking typical antipsychotics had a higher risk of parkinsonism than those on atypical agents. High-dose atypical antipsychotics showed a similar parkinsonism risk to typical antipsychotics, warranting caution.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Neurology
Background:
- Atypical antipsychotics are presumed to have a lower risk of parkinsonism compared to typical agents.
- This presumed benefit has not been extensively documented in scientific literature.
- This study investigates the comparative risk of parkinsonism in older adults using atypical versus typical antipsychotics.
Purpose of the Study:
- To compare the risk of developing parkinsonism in older adults prescribed atypical antipsychotics versus typical antipsychotics.
- To examine the influence of antipsychotic potency and dosage on parkinsonism risk.
Main Methods:
- A retrospective cohort study was conducted on adults aged 66 and older in Ontario.
- Cox proportional hazards models were utilized to analyze the association between antipsychotic type, potency, dose, and parkinsonism development over one year.
- Data from 25,769 older adults prescribed antipsychotics were analyzed.
Main Results:
- Individuals prescribed typical antipsychotics were 30% more likely to develop parkinsonism compared to those on atypical agents.
- Higher-potency typical antipsychotics significantly increased the risk of parkinsonism (HR, 1.44).
- The risk of parkinsonism with high-dose atypical antipsychotics was comparable to that of typical antipsychotics.
Conclusions:
- High-dose atypical antipsychotics carry a similar risk of parkinsonism as typical antipsychotics.
- Prescribers should exercise caution when administering high doses of atypical antipsychotic medications to older adults.
- The findings highlight the importance of considering antipsychotic type and dose in managing parkinsonism risk.