Antipsychotic Use in Parkinson’s Ups Physical Morbidity Risks

PHILADELPHIA—Antipsychotic (AP) use in Parkinson’s disease (PD) patients is associated with increased physical morbidity, according to a study in the American Journal of Geriatric Psychiatry.1

The study, led by researchers from the Parkinson’s Disease Research, Education and Clinical Center at the Philadelphia VAMC, utilized VHA data from 1999-2010 to examine physical morbidity risk associated with AP use in idiopathic PD patients with stable recent physical health.

The study team compared 180-day morbidity rates in patients initiating an AP with matched non-AP users who survived for 180 days. The 6,679 PD pairs were matched on a range of factors, including age, sex, race, index year, presence and duration of dementia, PD duration, delirium, hospitalization, Charlson Comorbidity Index and new nonpsychiatric medications.

To determine outcomes, the researchers tracked 180-day emergency department (ED), and inpatient and outpatient visits.

Results indicated that any AP use was associated with an increased risk of ED visit, for a hazard ratio of 1.64; inpatient care (1.58) and outpatient visits (1.08). The risk was significantly higher for atypical AP use compared with nonuse for all three morbidity outcomes, although it was similar for atypical and typical AP use.

“Any AP use, and atypical AP use, are associated with significantly increased physical morbidity risk in PD patients, as evidenced by increased ED, inpatient, and outpatient visits,” study authors concluded. “These findings, which require replication, extend the risk associated with use of APs in this population from mortality to a broader range of adverse outcomes, and further highlight the need to use APs cautiously in PD patients.”

Weintraub D, Chiang C, Kim HM, Wilkinson J, Marras C, Stanislawski B, Mamikonyan E, Kales HC. Antipsychotic Use and Physical Morbidity in Parkinson’s Disease. Am J Geriatr Psychiatry. 2017 Feb 2. pii: S1064-7481(17)30093-3. doi:

10.1016/j.jagp.2017.01.076. [Epub ahead of print] PubMed PMID: 28259697.

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