Antipsychotic use increases head and traumatic brain injury risk in people with Alzheimer’s disease, according to Finnish researchers. Clinicians should restrict prescriptions to cases of severe need, they say.

Investigators compared outcomes among nearly 22,000 adults with Alzheimer’s who either did or did not take antipsychotic medications. Those who took the drugs had 29% greater odds of head injury, and a 22% higher risk of traumatic brain injury.

“Persons with Alzheimer’s disease have a higher risk of falling, head injuries, and traumatic brain injuries and worse prognosis after these events in comparison to those without Alzheimer’s disease,” said lead author Vesa Tapiainen, M.D., from the University of Eastern Finland. “It is important to avoid further increasing risk with antipsychotics in this vulnerable population, if possible.”

“[Antipsychotic] use should be restricted to most severe neuropsychiatric symptoms, as recommended by the AGS Beers Criteria,” the research team concluded.

Medication type also appeared to influence risk. Quetiapine users were 60% more likely to acquire traumatic brain injuries when compared with risperidone users, the researchers reported. But they cautioned that this striking result must be confirmed.

Full findings were published this month in the Journal of the American Geriatrics Society.