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Risk of serious cardiac events in older adults using antipsychotic agents

Sandhya Mehta1, Hua Chen, Michael Johnson

  • 1Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Texas Medical Center, Houston, USA.

The American Journal of Geriatric Pharmacotherapy
|May 14, 2011
PubMed
Abstract

Insights

Older adults taking typical antipsychotics face a higher risk of serious cardiac events compared to those on atypical antipsychotics. Healthcare providers should carefully weigh the benefits and risks before prescribing these medications.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Antipsychotic medications can cause severe cardiovascular adverse events through electrophysiologic and metabolic pathways.
  • Limited epidemiologic data exists on the cardiovascular risks associated with typical and atypical antipsychotic use.

Purpose of the Study:

  • To compare the risk of serious cardiac events in older adults using typical antipsychotics versus atypical antipsychotics.

Main Methods:

  • Retrospective cohort study of adults aged 50+ using antipsychotics (July 2000–December 2007).
  • Data sourced from IMS LifeLink Health Plan Claims database.
  • Propensity score matching and survival analysis used to compare risks of cardiac events (hospitalization/ER visit) within one year.

Main Results:

  • After matching, 5580 patients were in each group (typical vs. atypical antipsychotic users).
  • Serious cardiac events occurred in 11.9% of atypical users and 12.4% of typical users.
  • Typical antipsychotic users showed a significantly increased risk of serious cardiovascular events (Hazard Ratio = 1.21, 95% CI: 1.04-1.40).

Conclusions:

  • Typical antipsychotic agents are associated with a moderately increased risk of serious cardiac events in older adults compared to atypical agents.
  • Healthcare professionals must carefully assess the benefit-risk profile of antipsychotics for this vulnerable population.

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