In Reply We appreciate the thoughtful comments by Malaty et al regarding our recent publication in JAMA Neurology reporting an increased risk for mortality associated with antipsychotic use in Parkinson disease (PD).1 They noted that the study did not focus on patients with PD and psychosis specifically, a potential limitation as psychosis itself confers an increased risk for mortality in PD.2 While that is true, we did include a comorbid diagnosis of psychosis as a covariate in all models, and the increased risk for mortality associated with antipsychotic use remained statistically significant even when controlling for the presence of psychosis. In addition, the similar, extensive, and well-accepted research reporting an association between antipsychotic use and mortality in patients with general dementia is not specific to patients with psychosis.3
Weintraub D, Kales HC, Marras C. The Danger of Not Treating Parkinson Disease Psychosis—Reply. JAMA Neurol. 2016;73(9):1156–1157. doi:10.1001/jamaneurol.2016.2274
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