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Antipsychotics up risk of death, cardiopulmonary arrest in hospitalized adults

05 Dec 2019
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The use of antipsychotic medications may increase mortality or cardiopulmonary arrest risk in hospitalized adults, a recent study has shown.

Researchers retrospectively assessed 150,948 hospitalizations for the influence of typical (n=1,419) and atypical (n=9,169) antipsychotic administration on clinical outcomes, such as deaths and cardiopulmonary arrests. Majority (n=139,098) of these were unexposed. Antipsychotic classification was based on Food and Drug Administration guidelines.

There were 691 outcome events reported, 515 of which were deaths and the remaining 176 were cardiopulmonary arrest episodes. Events were more frequent in patients exposed to typical (2.5 percent) and atypical (0.9 percent) antipsychotics, as well as to both (2.2 percent), relative to those who were unexposed (0.4 percent).

In absolute terms, patients who were exposed to antipsychotics experienced 0.15 events per 100 hospitalization-days, as opposed to only 0.08 per 100 hospitalization-days in the unexposed arm.

Cox proportional hazards analysis, adjusted for time-dependent and fixed variables, showed that typical antipsychotic medication significantly increased the risk of cardiopulmonary arrest or death relative to those who were not exposed to such drugs (hazard ratio [HR], 1.6, 95 percent confidence intervals [CI], 1.1–2.4). Atypical agents, on the other hand, had no such effect (HR, 1.1, 95 percent CI, 0.8–1.4).

“[I]n a cohort of hospitalized adults from a large academic medical centre, typical antipsychotic exposure was significantly associated with in-hospital death or cardiopulmonary arrest,” said researchers. “Inpatient providers should be thoughtful when prescribing antipsychotic medications, especially in settings where few data are available regarding benefit.”

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Most Read Articles
2 days ago
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Pank Jit Sin, 14 Apr 2020
With the movement control order (MCO) in full gear, most conferences and meetings are being postponed or cancelled. Some have taken to having conferences and meetings in a virtual setting, such as the recently ended American College of Cardiology/World Congress of Cardiology (ACC.20/WCC) conference. MIMS and the Asian Young Pharmacist Group (AYPG) took this opportunity to engage with pharmacists in the form of a Zoom meeting. 
Pearl Toh, 05 Aug 2020
The direct oral anticoagulant apixaban may help prevent deaths when given at prophylactic or therapeutic doses in hospitalized COVID-19 patients with elevated D-dimer levels, according to an analysis presented during the ISTH 2020 Congress.