Monday April 2, 2012
WEDNESDAY, March 28 (HealthDay News) -- Antipsychotic drugs can
raise the risk of heart attack in older patients with dementia, a
new study suggests.
It's common to prescribe antipsychotics to older patients with
dementia to control symptoms such as agitation, hallucinations and
aggression. Previous studies have found that this use of the drugs
may be linked to an increased risk of stroke and death from all
causes.
But until now, the risk of heart attack associated with the use
of antipsychotic drugs in older people with dementia had been
"poorly examined," wrote study author Dr. Antoine Pariente, of
Universite Bordeaux Segalen in France, and colleagues.
They looked at nearly 11,000 patients, aged 66 and older, in
Quebec who were being treated with cholinesterase inhibitors for
dementia and were also prescribed antipsychotics.
Within a year of starting treatment with the antipsychotics, 1.3
percent of the patients had a heart attack. Compared to those not
taking antipsychotics, the risk of heart attack among those taking
them was 2.19 times higher for the first 30 days, 1.62 times higher
for the first 60 days, 1.36 times higher for the first 90 days, and
1.15 times higher for the first year.
"Our study results indicate that the use of [antipsychotic
medications] is associated with a modest increase in the risk of
[heart attack] among community-dwelling older patients with treated
dementia," the researchers wrote. "The increased risk seems to be
highest at the beginning of treatment and seems to decrease
thereafter, with the first month of treatment accounting for the
highest period of risk."
The study, which found an association between antipsychotic use
and heart attack but did not prove cause-and-effect, appeared
online March 26 in the Archives of Internal Medicine.
"Because [antipsychotic] use is frequent in patients with
dementia ... the increased risk of [heart attack] may have a major
public health effect, which highlights the need for communicating
such risk and for close monitoring of patients during the first
weeks of treatment," the authors concluded in a journal news
release.
Further research is required to learn more about why the use of
antipsychotic drugs in dementia patients may increase the risk of
heart attack, Dr. Sudeep Gill and Dr. Dallas Seitz, of Queen's
University in Kingston, Ontario, Canada, wrote in an accompanying
editorial.
"Meanwhile, physicians should limit prescribing of antipsychotic
drugs to patients with dementia and instead use other techniques
when available, such as environmental and behavioral strategies, to
keep these patients safe and engaged," they suggested.
While the study found an association between antipsychotic drugs
and heart attack risk, it did not prove a cause-and-effect
relationship.
SOURCE: JAMA/Archives journals, news release, March 26, 2012