Antipsychotic Use and Physical Morbidity in Parkinson Disease

Daniel Weintraub, Claire Chiang, Hyungjin Myra Kim, Jayne Wilkinson, Connie Marras, Barbara Stanislawski, Eugenia Mamikonyan, Helen C. Kales

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective To determine if antipsychotic (AP) use in Parkinson disease (PD) patients is associated with increased physical morbidity. Methods Veterans Health Administration data (1999–2010) was used to examine physical morbidity risk associated with AP use in idiopathic PD patients with stable recent physical health. We compared 180-day morbidity rates in patients initiating an AP with matched non-AP users who survived for 180 days (matched on age, sex, race, index year, presence and duration of dementia, PD duration, delirium, hospitalization, Charlson Comorbidity Index, and new non-psychiatric medications; covarying for psychosis). Outcomes were 180-day emergency department (ED), and inpatient and outpatient visits. Results There were 6,679 matched PD pairs. Any AP use was associated with an increased risk of ED visit (HR: 1.64, 95% CI: 1.51, 1.77), inpatient care (HR: 1.58, 95% CI: 1.46, 1.71), and outpatient visits (IRR: 1.08, 95% CI: 1.05, 1.12). The risk was significantly higher for atypical AP use compared with nonuse for all three morbidity outcomes, and was similar for atypical and typical AP use. Conclusions Any AP use, and atypical AP use, are associated with significantly increased physical morbidity risk in PD patients, as evidenced by increased ED, inpatient, and outpatient visits. These findings, which require replication, extend the risk associated with use of APs in this population from mortality to a broader range of adverse outcomes, and further highlight the need to use APs cautiously in PD patients.

Original languageEnglish (US)
Pages (from-to)697-705
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Volume25
Issue number7
DOIs
StatePublished - Jul 2017
Externally publishedYes

Keywords

  • Antipsychotic
  • morbidity
  • Parkinson disease
  • psychosis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Antipsychotic Use and Physical Morbidity in Parkinson Disease'. Together they form a unique fingerprint.

  • Cite this

    Weintraub, D., Chiang, C., Kim, H. M., Wilkinson, J., Marras, C., Stanislawski, B., Mamikonyan, E., & Kales, H. C. (2017). Antipsychotic Use and Physical Morbidity in Parkinson Disease. American Journal of Geriatric Psychiatry, 25(7), 697-705. https://doi.org/10.1016/j.jagp.2017.01.076