Risk for Death with Antipsychotics in Patients with Dementia

Despite recent Health Canada and FDA advisories and warnings regarding adverse cerebrovascular effects of atypical antipsychotic medications in elderly patients, few if any alternatives exist for calming agitated, aggressive, and psychotic patients with dementia. In this meta-analysis, researchers calculated odds ratios and risk differences for death with atypical antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). Data came from fifteen 10-to-12–week, randomized, placebo-controlled, published or unpublished studies involving 5110 elderly patients with dementia. Calculations were based on total exposure to medication.

Dropout rates did not differ between medication and placebo groups. Incidence rates of death were 3.5% wit…