Age effect of antipsychotic medications on the risk of sudden cardiac death in patients with schizophrenia: A nationwide case–crossover study

Pao Huan Chen, Shang Ying Tsai, Chun Hung Pan, Chi Kang Chang, Sheng Shiang Su, Chiao Chicy Chen, Chian Jue Kuo

研究成果: 雜誌貢獻文章同行評審

摘要

Aim: Research regarding the effects of age in patients with schizophrenia taking antipsychotics on the risk of sudden cardiac death is lacking. We determined the effect of patient age on the association between exposure to antipsychotics and the risk of sudden cardiac death in a nationwide schizophrenia cohort. Methods: From the Taiwan National Health Insurance Research Database and Department of Health Death Certification System, data of 1836 patients with schizophrenia who had experienced sudden cardiac death between 2000 and 2016 were included. A case–crossover design by using a 14-day window was applied, and subgroup analyses were performed by stratifying patients into three age subgroups (<45, 45–65, and >65 years) to assess the effect of age on the risk of sudden cardiac death in patients taking antipsychotics. Results: No association between exposure to antipsychotic agents and sudden cardiac death risk was found in patients aged >65 years who were characterized by a high burden of medical illnesses. However, zotepine significantly increased the risk of sudden cardiac death in patients aged <45 years (adjusted relative risk [RR] = 2.68, P = 0.046). Flupentixol (adjusted RR = 5.30, P = 0.004) and risperidone (adjusted RR = 1.68, P = 0.01) significantly elevated the risk of sudden cardiac death in patients aged 45–65 years. Conclusion: This study suggests that individual antipsychotics pose different risks of sudden cardiac death in patients with schizophrenia across their lifespan. Clinicians should consider patient age when evaluating the risks and benefits of antipsychotic treatment.
原文英語
頁(從 - 到)594-601
頁數8
期刊Psychiatry and Clinical Neurosciences
74
發行號11
DOIs
出版狀態已發佈 - 十一月 1 2020

ASJC Scopus subject areas

  • Neuroscience(all)
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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