Nursing home residents being treated for dementia with the antipsychotic drug haloperidol were at a two-fold risk of mortality compared to other antipsychotics, a new study finds.

The use of antipsychotics to treat dementia is controversial in nursing homes, and regulators have raised the alarm about the increased risk of death in residents taking them. Reducing the off-label use of antipsychotics is a top priority of some provider groups.

In an attempt to determine which antipsychotics are more problematic, researchers from Harvard evaluated the mortality risk of several antipsychotic drugs in 75,445 nursing home residents who were over the age of 65. In addition to haloperidol, the investigators studied the mortality rates of aripiprazole, olanzapine, quetiapine, risperidone and ziprasidone.

After controlling for factors such as residents’ ethnicity, age and gender, as well as the facility’s size, occupancy rate and other factors, the researchers determined that risk for mortality varies from medication to medication, but that haloperidol had a higher risk. 

The study was published online in BMJ.