Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Thompson says criminal justice policies led to creation of prison gangs like Aryan Brotherhood

Schmitz finds job loss before retirement age contributes to weight gain, especially in men

Kimball says Fed should get comfortable with "backtracking"

Highlights

Overview of Michigan's advanced research computing resources, Monday, June 27, 9-10:30 am, BSRB - Kahn Auditorium

U-M's Data Science Initiative offers expanded consulting services via CSCAR

Elizabeth Bruch promoted to Associate Professor

Susan Murphy elected to the National Academy of Sciences

Next Brown Bag

PSC Brown Bags
will resume fall 2016

Trends in Antipsychotic Use in Dementia 1999-2007

Archived Abstract of Former PSC Researcher

Kales, H.C., Kara Zivin, H.M. Kim, M. Valenstein, C. Chiang, R. Ignacio, D. Ganoczy, F. Cunningham, L.S. Schneider, and F.C. Blow. 2011. "Trends in Antipsychotic Use in Dementia 1999-2007." Archives of General Psychiatry, 68(2): 190-197.

Context: Use of atypical antipsychotics for neuropsychiatric symptoms of dementia increased markedly in the 1990s. Concerns about their use began to emerge in 2002, and in 2005, the US Food and Drug Administration warned that use of atypical antipsychotics in dementia was associated with increased mortality. Objective: To examine changes in atypical and conventional antipsychotic use in outpatients with dementia from 1999 through 2007. Design: Time-series analyses estimated the effect of the various warnings on atypical and conventional antipsychotic usage using national Veterans Affairs data across 3 periods: no warning (1999-2003), early warning (2003-2005), and black box warning (2005-2007). Subjects: Patients aged 65 years or older with dementia (n=254 564). Main Outcome Measures: Outpatient antipsychotic use (percentage of patients, percentage of quarterly change, and difference between consecutive study periods). Results: In 1999, 17.7% (95% confidence interval [CI], 17.2-18.1) of patients with dementia were using atypical or conventional antipsychotics. Overall use began to decline during the no-warning period (rate per quarter, -0.12%; 95% CI, -0.16 to -0.07; P<.001). Following the black box warning, the decline continued (rate,-0.26%; 95% CI, -0.34 to -0.18; P<.001), with a significant difference between the early and black box warning periods (P=.006). Use of atypical antipsychotics as a group increased during the no-warning period (rate, 0.23; 95% CI, 0.17-0.30; P<.001), started to decline during the early-warning period (rate, -0.012; 95% CI, -0.14 to 0.11; P=.85), and more sharply declined during the black box warning period (rate, -0.27; 95% CI, -0.36 to -0.18; P<.001). Olanzapine and risperidone showed declining rates and quetiapine showed an increase during the early-warning period, but rates of use for all 3 antipsychotics declined during the black box warning period. In the black box warning period, there was a small but significant increase in anticonvulsant prescriptions (rate, 0.117; 95% CI, 0.08-0.16; P<.001). Conclusions: Use of atypical antipsychotics began to decline significantly in 2003, and the Food and Drug Administration advisory was temporally associated with a significant acceleration in the decline.

Country of focus: United States of America.

Browse | Search : All Pubs | Next