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Metabolic side effects of atypical antipsychotics in older adults

Published online by Cambridge University Press:  25 May 2018

Emme Chacko ,
Stephen Boyd  and
Rinki Murphy
Emme Chacko
Affiliation:
Mental Health Service for Older People, Auckland District Health Board, Auckland, New Zealand
Stephen Boyd*
Affiliation:
Mental Health Service for Older People, Auckland District Health Board, Auckland, New Zealand
Rinki Murphy
Affiliation:
Auckland Diabetes Centre, Auckland District Health Board, Auckland, New Zealand Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
*
Correspondence should be addressed to: Dr. Stephen Boyd, Mental Health Services for Older People, Building 14, Greenlane Clinical Centre, Private Bag 92189, Auckland, New Zealand. Email: [email protected].
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Abstract

Background:

The atypical antipsychotics (AAPs) are associated with a recognized class effect of glucose and lipid dysregulation. The use of these medications is rapidly increasing in elderly patients with, and without, dementia. However, the metabolic risks specific to elderly remain poorly studied.

Methods:

Design: A case-control study.

Setting: Psychogeriatric service in Auckland, New Zealand.

Participants: Elderly patients either receiving AAP treatment (cases) or not (controls) between 1 Jan 2008 and 1 Jan 2014.

Main outcome measures: metabolic data of glucose, HbA1c, lipids, and cardiovascular events and death. The data were analyzed using t-tests and linear regression models for each metabolic outcome.

Results:

There were 330 eligible cases and 301 controls from a total study population of 5,307. There was a statistically significant change in the HbA1c over time, within the cases group of −1.14 mmol/mol (p = 0.018, 95% CI −0.19 to −2.09). Also statistically significant was the reduction in total cholesterol of −0.13 mmol/L (p = 0.036, 95% CI −0.008 to −0.245). The only significant difference found between cases and controls was in the change in cholesterol ratio of 0.16 mmol/L between groups (95%CI 0.01–0.31, p = 0.036).

Conclusions:

AAP use was not associated with any clinically significant change in metabolic outcomes in this study population.

Keywords

elderlyatypical antipsychoticsmetabolic changes
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 10: Issue Theme: Mild Cognitive Impairment , October 2018 , pp. 1557 - 1566
Copyright
Copyright © International Psychogeriatric Association 2018 

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