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Profile and variables related to antipsychotic consumption according to dementia subtypes

Published online by Cambridge University Press:  14 February 2012

Laia Calvó-Perxas ,
Rosa María de Eugenio ,
Fabian Marquez-Daniel ,
Raül Martínez ,
Joaquín Serena ,
Josefa Turbau ,
Joan Vilalta-Franch ,
Marta Viñas ,
Oriol Turró-Garriga  and
Anna Maria Roig
...Show all authors
Laia Calvó-Perxas
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Girona, Spain
Rosa María de Eugenio
Affiliation:
Dementia Unit, Hospital de Palamós, Palamós, Girona, Spain
Fabian Marquez-Daniel
Affiliation:
Neurology Department, Hospital d'Olot, Olot, Girona, Spain
Raül Martínez
Affiliation:
Neurology Unit, Hospital de Figueres, Figueres, Girona, Spain
Joaquín Serena
Affiliation:
Neurodegenerative Disease Unit, Hospital Universitari Dr. Josep Trueta, Girona, Spain
Josefa Turbau
Affiliation:
Neurology Department, Hospital de Campdevànol, Campdevànol, Girona, Spain
Joan Vilalta-Franch
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Girona, Spain Dementia Unit, Hospital de Santa Caterina, Salt, Girona, Spain
Marta Viñas
Affiliation:
Geriatrics and Neurology Department, Hospital de Blanes, Blanes, Girona, Spain
Oriol Turró-Garriga
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Girona, Spain
Anna Maria Roig
Affiliation:
Pharmacy Unit, Health Region of Girona, Girona, Spain
Secundino López-Pousa*
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Girona, Spain Dementia Unit, Hospital de Santa Caterina, Salt, Girona, Spain
Josep Garre-Olmo
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Girona, Spain Department of Psychology, University of Girona, Girona, Spain
*
Correspondence should be addressed to: Secundino López-Pousa, PhD, Research Unit, Institut d'Assistència Sanitària, C/Dr Castany s/n, 17190 Salt, Girona, Spain. Phone: +34-972-18-26-00. Email: uvamid@ias.scs.es.
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Abstract

Background: Antipsychotics (APs) are usually prescribed to deal with behavioral and psychological symptoms of dementia (BPSD), but poor outcomes, important side effects, and high mortality risk should be addressed. The aim of this study was to estimate the prevalence of AP consumption in patients with dementia, and to describe and compare the sociodemographic and clinical characteristics of patients consuming APs.

Methods: This was a cross-sectional study using 1,894 cases of dementia registered from 2007 to 2009 by the Registry of Dementias of Girona (ReDeGi), which is a population-based passive surveillance system of dementia diagnoses. APs were categorized according to the anatomical therapeutic chemical (ATC) classification, and grouped as typical antipsychotics (TAPs) or atypical antipsychotics (AAPs). Binary logistic regression analyses were used to detect the predictors of AP use as well as the variables associated with TAP or AAP prescription.

Results: APs were used in 29.6% of the cases, with Parkinsonian syndromes (PSd) being the subtype of dementia with the highest AP prescription (50.6% of the patients with PSd). AAPs were mainly prescribed in all subtypes of dementia, except in vascular dementia (VaD) and PSd, where no preference in TAP or AAP use was found. Psychotic antecedents, dementia with Lewy bodies (DLB) diagnoses, cognitive impairment, and BPSD were AP use predictors. AAP use was related to higher severity of dementia.

Conclusions: Despite their disputed benefit–risk ratios, APs are extensively used, off-label, to treat BPSD, and AAPs are more commonly prescribed than TAPs. AP consumption was frequent in DLB, and was related to dementia severity indicators.

Keywords

antipsychoticsbehavioral and psychological symptoms of dementia (BPSD)dementiadementia with Lewy bodies (DLB)epidemiology
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 6 , June 2012 , pp. 940 - 947
Copyright
Copyright © International Psychogeriatric Association 2012

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