Long-term antipsychotic polypharmacy prescribing in secondary mental health care and the risk of mortality.

Acta Psychiatrica Scandinavica
Giouliana KadraRichard D Hayes

Abstract

To investigate the association between long-term antipsychotic polypharmacy use and mortality; and determine whether this risk varies by cause of death and antipsychotic dose. Using data from a large anonymised mental healthcare database, we identified all adult patients with serious mental illness (SMI) who had been prescribed a single antipsychotic or polypharmacy, for six or more months between 2007 and 2014. Multivariable Cox regression models were constructed, adjusting for sociodemographic, socioeconomic, clinical factors and smoking, to examine the association between APP use and the risk of death. We identified 10 945 adults with SMI who had been prescribed long-term antipsychotic monotherapy (76.9%) or APP (23.1%). Patients on long-term APP had a small elevated risk of mortality, which was significant in some but not all models. The adjusted hazard ratios for death from natural and unnatural causes associated with APP were 1.2 (0.9-1.4, P = 0.111) and 1.1 (0.7-1.9, P = 0.619) respectively. The strengths of the associations between APP and mortality outcomes were similar after further adjusting for % BNF antipsychotic dose (P = 0.031) or olanzapine equivalence (P = 0.088). The findings suggest that the effect of long-te...Continue Reading

References

Sep 1, 1992·The American Journal of Psychiatry·D C GoffE Amico
Feb 2, 1999·The British Journal of Psychiatry : the Journal of Mental Science·J L WaddingtonA Kinsella
Sep 9, 2000·Schizophrenia Research·U OsbyP Sparén
Oct 21, 2000·The British Journal of Psychiatry : the Journal of Mental Science·S BrownB Barraclough
Dec 4, 2001·The British Journal of Psychiatry : the Journal of Mental Science·M JoukamaaV Lehtinen
Feb 12, 2005·The Journal of Clinical Psychiatry·Donald C GoffFrank M Sacks
Feb 2, 2006·The British Journal of Psychiatry : the Journal of Mental Science·Matti JoukamaaVille Lehtinen
Apr 25, 2006·Schizophrenia Research·Julie KreyenbuhlFrederic C Blow
Oct 24, 2006·Pharmacoepidemiology and Drug Safety·Pascal AuquierCatriona Holmes
Apr 7, 2007·Psychiatric Services : a Journal of the American Psychiatric Association·Julie A KreyenbuhlFrederic C Blow
Oct 24, 2007·Experimental Physiology·Denis Noble
Jun 3, 2008·The British Journal of Psychiatry : the Journal of Mental Science·Carol PatonUNKNOWN POMH-UK project team
Jan 16, 2009·The New England Journal of Medicine·Wayne A RayC Michael Stein
Apr 3, 2010·The American Journal of Psychiatry·David M GardnerRoss J Baldessarini
Sep 15, 2010·Current Opinion in Psychiatry·Thomas J Raedler
May 9, 2012·Archives of General Psychiatry·Jari TiihonenPasi Korhonen
Aug 30, 2012·The Psychiatric Clinics of North America·Christoph U Correll, Juan A Gallego
Sep 8, 2012·The British Journal of Psychiatry : the Journal of Mental Science·Oliver D HowesDavid Taylor
Feb 16, 2013·Journal of Psychopharmacology·Marc W H Lochmann van BennekomFrans G Zitman
May 15, 2013·The Australian and New Zealand Journal of Psychiatry·Daeyoung RohYoung-Chul Jung
Jul 13, 2013·Schizophrenia Research·Maxine X PatelThomas R E Barnes
Aug 15, 2013·Schizophrenia Bulletin·Faith DickersonRobert Yolken
Feb 1, 2012·Therapeutic Advances in Psychopharmacology·Patrice Grech, David Taylor
Sep 30, 2014·Schizophrenia Bulletin·Ulrich ReininghausPeter B Jones
Nov 26, 2014·Schizophrenia Bulletin·Minna TorniainenJari Tiihonen
Dec 10, 2014·Therapeutic Advances in Psychopharmacology·Anne Connolly, David Taylor
Feb 4, 2016·PloS One·Corrado BarbuiUNKNOWN STAR NETWORK INVESTIGATORS
Jun 17, 2016·European Psychiatry : the Journal of the Association of European Psychiatrists·J M MoilanenJ Miettunen

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Citations

Jan 8, 2020·Basic & Clinical Pharmacology & Toxicology·Lone Baandrup
Dec 24, 2019·The International Journal of Neuropsychopharmacology·Shih-Ku Lin
Sep 16, 2020·Expert Opinion on Drug Metabolism & Toxicology·Jean-Michel Azorin, Nicolas Simon
Sep 25, 2021·BMJ Quality & Safety·Ian MaidmentCarolyn Chew-Graham
Oct 26, 2021·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Jung-Jin KimPrakash S Masand

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Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

Clinical Records Interactive Search ( CRIS )
stata
Clinical Record Interactive Search ( CRIS )
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