Ventricular Arrhythmias and Cerebrovascular Events in Elderly Using Conventional and Atypical Antipsychotic Medications. Effective Health Care Research Report No. 9

摘要

Although an FDA Advisory has warned that atypical antipsychotic medications (APMs) increase mortality in older patients, evidence has been growing that conventional APM use may be associated with even greater risks of death. The objectives of the research was to identify intervening medical conditions that may be responsible for a greater risk of mortality from conventional vs. atypical APMs. The authors conducted a retrospective cohort study of 22,890 patients greater than or equal to 65 receiving pharmacy benefits in Pennsylvania who began a conventional or atypical APM between 1994-2003. Cox proportional hazards models were used to compare hazards of developing the following health outcomes within 30, 60, and 120 days since APM initiation: acute myocardial infarction, cerebrovascular events, congestive heart failure, pneumonia, other serious infections, and ventricular arrhythmias. The authors controlled for potential confounders using conventional multivariable models. Secondary confirmatory analyses employed methods based on propensity scores and instrumental variables.