Older adults are known to be more susceptible to medication‐related adverse events, owing to changes in body composition, declining renal function, altered drug metabolism, and greater polypharmacy, all of which result in alterations in the pharmacokinetics and pharmacodynamics.It is important to recognize that although the risk of death or cardiopulmonary arrest with atypical antipsychotics seemed to be restricted to older adults, atypical antipsychotics have other previously demonstrated risks in hospitalized patients including aspiration pneumonia and falls, and they should not be considered without risk even in younger adults.The reason for a reduced risk of cardiopulmonary arrest or death with atypical antipsychotic exposure in younger patients is unclear but could be due to differences in indications for use or residual confounding.Because our study was observational, and thus prone to confounding by severity of illness and indication, we performed several sensitivity analyses. We excluded 4918 psychiatric hospitalizations, 41 032 OB‐GYN hospitalizations, and 31 021 hospitalizations of patients who were admitted to the ICU on hospital day 1. antipsychotics in combination with other psychotropics; however, little is known about the safety of this practice. 1 0 obj Hospitalizations were censored at discharge or at hospitalization day 50 (impacted <1% of all hospitalizations).We included variables thought to represent potential confounders of the association between antipsychotic administration and death or cardiopulmonary arrest, selected a priori based on clinical grounds. Latest report adds almost 44,000 child COVID-19 cases in 1 week . Richard Franki.
This study found an increased mortality when antipsychotics were combined with benzodiazepines but a lower mortality when antipsychotics and antidepressants were combined. Second, the results of our subgroup analysis by age suggest that risk from antipsychotics, including atypical antipsychotics, may be specific to adults age 65 and older. In this approach, we excluded hospitalizations with exposure to both typical and atypical antipsychotics to create mutually exclusive groups and avoid having more than three treatment groups.

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Hospital Medicine, North Shore Medical Center, Salem, MassachusettsTufts University School of Medicine, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Hospital Medicine, North Shore Medical Center, Salem, MassachusettsTufts University School of Medicine, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsUse the link below to share a full-text version of this article with your friends and colleagues.
To investigate this possibility, we re‐ran our primary analysis separately in hospitalizations of patients age 65 and older, and in hospitalizations of those younger than age 65.We performed a sensitivity analysis in which we re‐ran our primary Cox proportional hazards model in the subset of patients with an ICD‐9‐CM or ICD‐10‐CM code for delirium.

Compazine® Prochlorperazine Suppositories USP is not approved for the treatment of patients with dementia-related psychosis (see BOXED WARNING).. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. In the matched cohort, the characteristics of unexposed and exposed patients are strikingly similar. /Type /Catalog In hospitalizations age 65 years and older, both typical (HR = 1.8; 95% CI = 1.1‐2.9) and atypical antipsychotics (HR = 1.4; 95% CI = 1.1‐2.0) were associated with increased risk of death or cardiopulmonary arrest.We were able to match 1411 of 1419 (99%) hospitalizations with typical antipsychotic exposure to a hospitalization with atypical exposure and a hospitalization with no exposure, for a total of 4233 hospitalizations in our propensity‐matched cohort. Use of antipsychotics was demonstrated to vary substantially across different hospitals, both in frequency and dosing.In conclusion, in a cohort of hospitalized adults from a large academic medical center, typical antipsychotic exposure was significantly associated with in‐hospital death or cardiopulmonary arrest. This association remained present when selecting for patients with a diagnosis of delirium and in a propensity‐matched cohort.