Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults

This study aims to investigate the effect of antipsychotic agents on cardiovascular and cerebrovascular diseases (CVD/CEV) and mortality risks in the older population living in a community. A cohort of 42,650 new users of antipsychotic agents was built using Quebec healthcare databases (1998-2011)....

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Bibliographic Details
Published in:Pharmaceuticals (Basel, Switzerland) Switzerland), 2024-01, Vol.17 (2), p.178
Main Authors: Perreault, Sylvie, Boivin Proulx, Laurie-Anne, Brouillette, Judith, Jarry, Stéphanie, Dorais, Marc
Format: Article
Language:English
Subjects:
Adults
Aged patients
Antipsychotic drugs
Antipsychotics
Cardiovascular diseases
Cerebrovascular disease
cerebrovascular diseases and mortality
Dementia
Demographic aspects
Dosage and administration
Drug dosages
Drug therapy
Mortality
Older people
Patient outcomes
Psychotropic drugs
risk of cardiovascular diseases
Schizophrenia
Stroke
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Summary:This study aims to investigate the effect of antipsychotic agents on cardiovascular and cerebrovascular diseases (CVD/CEV) and mortality risks in the older population living in a community. A cohort of 42,650 new users of antipsychotic agents was built using Quebec healthcare databases (1998-2011). The outcomes were CVD/CEV and mortality incidence in 5 years of follow-up in the total cohort, sub-cohort of patients with no schizophrenia/dementia, sub-cohort with schizophrenia, and sub-cohort with dementia. Comparisons were made between the new users who continued the treatment (adherent level ≥ 60%) vs. those ceasing treatment (adherence level < 60%) using inverse probability of treatment weighting and Cox models. Comparing high adherence vs. low levels, CVD/CEV risk was increased by 36% in the sub-cohort with schizophrenia for atypical antipsychotic users and by 25% in the sub-cohort with dementia for typical antipsychotic users. An increasing mortality risk of 2- to 3-fold was linked with the typical antipsychotic use in all cohorts except the sub-cohort with schizophrenia; in addition, mortality risk is linked with the use of high vs. low doses. Antipsychotics were not linked with CVD/CEV risk, except for atypical antipsychotics in patients with schizophrenia and typical antipsychotics in patients with dementia. The mortality risk was linked with the use of typical antipsychotics and the dose used.
ISSN:1424-8247
1424-8247
DOI:10.3390/ph17020178