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Invited Commentary
Apr 23, 2012

From Association to Mechanism: Comment on “Antipsychotic Use and Myocardial Infarction in Older Patients With Treated Dementia”

Author Affiliations

Author Affiliations: Departments of Medicine (Dr Gill) and Psychiatry (Dr Seitz), Queen's University, Kingston, Ontario, Canada.

Arch Intern Med. 2012;172(8):654-655. doi:10.1001/archinternmed.2012.682

Antipsychotic medications are prescribed routinely to manage various neuropsychiatric symptoms in older adults with dementia. In recent years, atypical antipsychotics (eg, risperidone, olanzapine, and quetiapine fumarate) have essentially replaced older typical agents, such as haloperidol, in this setting. Although widespread use of antipsychotics to treat older persons with dementia persists, there has been increasing recognition of the serious adverse effects associated with these medications. In 2005, evidence emerged that antipsychotic treatment increased overall mortality among older adults with dementia.1 The increased risk for death associated with antipsychotic use has raised several important questions, and among them is the question of how exposure to these drugs leads to death.