Antipsychotics May Increase Risk of Death in Parkinson’s Disease Patients: Study

Individuals with Parkinson’s disease who take antipsychotic medications may face an increased risk of death, according to the findings of a new study. 

Researchers say patients with Parkinson’s disease who are given antipsychotic medications, such as Risperdal and Zyprexa, had more than twice the risk of death in the six months after taking the medications than patients with Parkinson’s Disease who didn’t take the antipsychotics. The findings were published in the May issue of JAMA Neurology.

The study was conducted by researchers with Veterans Affairs centers in Pennsylvania and Michigan, who noted that prior data indicates as many as 60% of patients with Parkinson’s Disease experience psychosis and 80% develop dementia. However, the use of antipsychotics by patients with dementia has already been linked to an increased risk of death. The study sought to see if that increased mortality risk extended to Parkinson’s disease patients as well.

Researchers used data from the Veterans Health Administration database from 1999 to 2010 to examine the risk associated with antipsychotic use in patients with Parkinson’s Disease. Those patient’s had to be in recent stable physical health.

Data for more than 7,800 patients initiating antipsychotic therapy was compared to data from nearly 7,900 patients who did not have antipsychotic therapy. They were matched for age, sex, race, and other factors.

Researchers found at 180 days the mortality rates of patients who took antipsychotics were much higher compared with matched patients. The patients who took antipsychotics died in much larger numbers.

The findings of this study are concerning as a 2015 report revealed nursing home patients with dementia are often treated with antipsychotics, like Zyprexa or Risperdal, as a chemical restraint to control difficult behavior, placing these patients at even higher risk of death.

Antipsychotic use was associated with more than twice the risk of death compared to not using antipsychotics in the six months after taking the medications.

The risk of death was also higher for patients who used a class of drugs known as atypical antipsychotics. Among atypical antipsychotics, the death risk was nearly three times higher for patients taking Zyprexa, 2.5 times higher for those taking Risperdal, and five times higher death risk for those taking Haldol.

Antipsychotic drugs have some serious potential side effects, including reduced alertness, decreased blood pressure, increased risk of diabetes and heart disease, and even movement disorders that resemble those seen in Parkinson’s.

Researchers warn that antipsychotic drugs shouldn’t be prescribed to Parkinson’s patients without careful consideration. They should be given only after looking for other possible solutions, treating the patient for other medical conditions and attempting to manage the disease without antipsychotics.

Antipsychotics should only be used when psychosis is of clinical significance and patients should not be left on the drugs long-term without re-evaluation.

“Use of APs [antipsychotics] is associated with a significantly increased mortality risk in patients with PD [Parkinson’s Disease],” wrote study authors. “This finding highlights the need for cautious use of APs in patients with PD. Future studies should examine the role of nonpharmacologic strategies in managing psychosis in PD.”