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Reduced Atypical Antipsychotic Use Among Older Adults With Dementia Seen After FDA Warnings
Clozapine, the first second-generation or "atypical" antipsychotic medication, was introduced in the United States in 1989, according to background information in the article. Several additional drugs, including risperidone, olanzapine and paliperidone, followed. Although they are less likely to cause neurological adverse effects associated with conventional or "typical" antipsychotics, some reports have linked atypical antipsychotics to strokes, diabetes and other severe adverse events. In April 2005, the FDA issued a public health advisory that asked manufacturers to include a boxed warning regarding the increased risk of death associated with using atypical antipsychotics to treat behavioral symptoms in older patients with dementia (an off-label use of the drugs).
E. Ray Dorsey, M.D., M.B.A., of the University of Rochester Medical Center, New York, and colleagues analyzed nationally representative data to assess rates of atypical antipsychotic drug use between January 2003 and December 2008. Physicians participating in the national index recorded diagnoses, therapies and patient characteristics for all clinical encounters over a two-day period. The researchers calculated the number of patient-physician interactions during which an antipsychotic was mentioned as a therapy and compared time periods before and after the FDA warning was issued to quantify its effects.
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