Antipsychotic Medications Prescribed To Hospitalized Older Adults For Delirium Linked To Cardiopulmonary Arrest
Source: Thailand Medical News Jan 07, 2020 6 years, 1 month, 2 weeks, 4 days, 43 minutes ago
The mental state of
Delirium (sudden confusion or a rapid change in mental state) remains a serious challenge for the
healthcare system.
Delirium affects 15 to 26 percent of hospitalized
older adults and can be particularly problematic because those experiencing the condition may interfere with medical care or directly harm themselves or others.
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Aside from behavioral therapy and physical restraints,
antipsychotic medicines are among the few therapeutic options
healthcare providers can use to ease
delirium and protect patients and caregivers but a new study shows that
antipsychotics also come with risks of their own.
To discover more about the effect of
antipsychotic medicines on
older hospitalized
adults, a research team created a study published in the
Journal of the American Geriatrics Society. This study included information from hospitalized patients at a large academic medical center in Boston.
The medical researchers looked specifically at death or non-fatal
cardiopulmonary arrest (
heart attack) during hospitalization.
The team learned that adults taking "first-generation" or "typical"
antipsychotic medications (medicines first developed around the 1950s) were significantly more likely to experience death or
cardiopulmonary arrest, compared to people who did not take those drugs. Taking "atypical" or "second-generation"
antipsychotics (so named because they were developed later) raised the risk for death or
cardiopulmonary arrest only for people aged 65 or older.
Previous other studies have suggested that typical
antipsychotic medications could cause sudden death, and that atypical
antipsychotics could raise peoples' risks for falls, pneumonia and death. What's more, another large study also suggested that both types of
antipsychotic medicines posed a risk for fatal
heart attacks.
Even with these known risks, atypical
antipsychotics are often prescribed for people in the hospital. One recent study of patients at Beth Israel Deaconess Medical Center in Boston found that
antipsychotics were prescribed for nine percent of all adults who were hospitalized for non-psychiatric causes. Another large recent study found that using
antipsychotics to prevent or treat
delirium did not lower the risk for death, did not lessen the severity of
delirium or shorten its duration, and did not shorten the time people spent in the intensive care unit (ICU) or their hospital length of stay.
The authors told
ot;>Thailand Medical News, "Delirium is common in older hospitalized patients and difficult to treat, but
antipsychotic medications should be used with caution regardless of age."
Reference : Matthew Basciotta et al, Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults, Journal of the American Geriatrics Society (2019). DOI: 10.1111/jgs.16246
