Warning! Antiepileptic And Psychotropic Drugs Linked To Increase Risk Of Pneumonia And Deaths In In Alzheimer's Patients And The Old
: A first study by researchers from University Od Eastern Findland highlights the fact that individuals with Alzheimer’s disease using antiepileptic drugs have twice the risk of pneumonia compared to non-users.
The study showed that the risk was highest in the beginning of use, but remained on an elevated level even in long-term use. The results were published in the Journal of Alzheimer’s Disease
The following drugs: phenytoin, carbamazepine, valproic acid and pregabalin were associated with an increased risk of pneumonia. Relatively few ie less than 10 per cent of the antiepileptic users had been diagnosed with epilepsy and thus, it is likely that many used these drugs for other indications, such as neuropathic pain and behavioral symptoms of dementia. Some antiepileptic drugs have sedative effects which may explain the associated risk of pneumonia.
The research was the first to be investigating antiepileptic use and the risk of pneumonia among persons with Alzheimer’s disease. A previous study assessed the risk among younger adults and did not find a risk increase.
Senior Researcher Heidi Taipale from the University of Eastern Finland told Thailand Medical News, “Further research into whether older persons are more sensitive to the effects of antiepileptic drugs is needed. Persons with Alzheimer’s disease have a higher risk of pneumonia and pneumonia-related mortality than persons without the disease. For this reason, it is important to carefully assess the risks and benefits of drug use, especially for other indications than epilepsy.
The research was based on the nationwide register-based MEDALZ study conducted at the University of Eastern Finland. For this study, 5,769 community-dwelling persons diagnosed with Alzheimer’s disease who initiated antiepileptic drug use in Finland were included and compared with matched non-users of these drugs.
Another study published in the journal Neurology showed that the same antiepileptic drugs are associated with a higher risk of death among people with Alzheimer's disease. https://n.neurology.org/content/94/20/e2099
The research showed that the increased risk remained after controlling for comorbidities, sociodemographic factors and the use of other drugs. However, it is possible that the reasons for initiating an antiepileptic partially explain the results and, therefore, the findings should be confirmed in further studies. According to the authors from University of Eastern Finland, death risk was higher among users of older antiepileptic drugs in comparison to users of newer antiepileptics.
Also the mortality risk was compared between antiepileptic drug users and matched non-users with Alzheimer's disease. The findings showed that the increased risk remained after controlling for comorbidities, sociodemographic factors and the use of other drugs. These initial findings are concerning, as people with Alzheimer's disease used antiepileptic drugs more frequently than people without the disease, and the use of older antiepileptics is more common among them, said the researchers.&l
The research results also highlight caution in prescribing these drugs for indications other than epilepsy in the vulnerable group. These drugs are also frequently used for other indications, including neuropathic pain and behavioral and psychological symptoms of dementia, although antiepileptics are not officially indicated for behavioral and psychological symptoms of dementia.
Meanwhile yet another study showed that the use of psychotropic drugs (antipsychotics, benzodiazepines and benzodiazepine-related drugs, and antidepressants) is common, with a prevalence estimates range of 19-29% among community dwelling older adults. These drugs are often prescribed for off-label use, including neuropsychiatric symptoms. The older adult population also has high rates of pneumonia and some of these cases may be associated with adverse drug events. These drugs are also associated with mortality rates among the old.
The study was published in the journal: Drug-Aging. https://pubmed.ncbi.nlm.nih.gov/32107741/
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