Common antipsychotics fuel doubts about safety, efficacy

Common antipsychotics fuel doubts about safety, efficacy

Piling onto the concerns about off-label use of antipsychotics, a new study has found four of the most common medications lack safety and effectiveness in older adults.

Researchers at the University of California, San Diego School of Medicine, Stanford University and the University of Iowa examined aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal) in 332 patients over five years. The subjects had diagnoses associated with schizophrenia, mood disorders, post-traumatic stress disorder or dementia. 

The investigators found a third of the patients developed metabolic syndrome within a year, and a fourth developed serious adverse effects after two years.

“While there were a few significant differences among the four drugs, the overall risk-benefit ratio for the AAPs in patients over age 40 was not favorable, irrespective of diagnosis and drug,” said Dilip V. Jeste, M.D., director of the Stein Institute for Research on Aging at UC San Diego. 

There was no placebo in the trial since all the patients had been diagnosed with conditions that required some antipsychotic treatment. The average length of time a patient was on a drug was  generally six months, as the medications had to be halted or switched because they no longer worked or had side effects.

Results were published in The Journal of Clinical Psychiatry on Nov. 27.