Monday, September 12, 2005

Parkinsonism with novel vs. typical antipsychotics

The current Archives of Internal Medicine takes a look at parkinsonism from newer vs. typical antipsychotics. It's a retrospective cohort study of elderly (>65 years old) demented Canadians using a public administrative database. Basically they compared people given typical vs. atypical vs. no antipsychotics & then looked at rates of diagnoses of parkinsonism or prescriptions for antiparkison drugs. Despite these obvious problems it's a worthwhile article. What's of note is that they found that rates of parkinsonism were similar between those taking high-doseatypicals & those taking typicals--the event rates were ~5 per 100 person-years. See the table for their definitions of high doses (I am experimenting with adding images to the blog & 1)am not sure if what I've done here is legal, & 2)am not sure if this looks good or is worth the effort). They note about 80% of the atypical use was risperidone & I'll note that 2mg a day of risperidone is not an atypical dose. All this adds to the growing body of literature that the newer antipsychotics clearly are associated with significant extrapyramidal side effects.

Click on the image for full-size.
Finally, there is this sentence in the middle of the methods section...

We excluded individuals receiving dialysis or palliative care, because these are potential contraindications to antipsychotic therapy [...]. Huh??

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