Antipsychotics May Increase Mortality Risk in Alzheimer's Patients

Treatment with haloperidol may double mortality risk for patients with Alzheimer’s disease.

Findings from a recent study suggest that the use of antipsychotic drugs may increase mortality risk among patients with Alzheimer’s disease.

While there is no cure for the disease, patients with Alzheimer’s may be prescribed antipsychotic drugs, such as aripiprazole (Abilify), haloperidol (Haldol), and risperidone (Risperdal). These drugs can potentially treat hallucinations, delusions, aggression, agitation, hostility, and uncooperativeness associated with the disease.

Although treatment with antipsychotics is generally advised against in these patients due to side effects, some studies have found that older patients with Alzheimer’s disease are 5 times more likely to use antipsychotics compared with individuals without the disease, which suggests that many patients are at a higher risk of mortality.

In a new study, the team of researchers discovered that the use of antipsychotics increased mortality risk by 60% among these patients, with the highest risk seen at the start of the treatment, according to the study published by the Journal of Alzheimer’s Disease. The use of 2 or more antipsychotics was also seen to double mortality risk compared with monotherapy.

In the study, investigators analyzed mortality risk among the most common antipsychotic drugs. There were 57,755 patients with Alzheimer’s disease included in the current study. All patients were diagnosed between 2005 and 2011.

The patients included were also a part of the Finnish MEDALZ study, did not use antipsychotics within 1 year prior to the follow-up period, had no history of mental illness, and did not have cancer at the time of follow-up. Approximately 27% of patients initiated treatment for Alzheimer’s disease symptoms with antipsychotics during the follow-up.

They found that haloperidol use was linked to the highest mortality risk, according to the study. High doses of haloperidol and risperidone were associated with higher risks compared with lower doses of the drugs.

These findings compliment the results of other studies, suggesting that concomitant use of multiple antipsychotic drugs can increase mortality risk. The first warnings about an association between increased mortality rate and antipsychotics first emerged more than 10 years ago, according to the study.

The results also reinforce current recommendations that these drugs should only be used in patients who are experiencing significant symptoms of Alzheimer’s disease, such as agitation and aggression. The use of antipsychotics in these patients should also be limited.

The researchers concluded that patients with Alzheimer’s disease who require treatment with antipsychotic drugs should receive low doses of the treatments, and should only take 1 of these drugs at a time.