Atypical antipsychotics and parkinsonism.
Identifieur interne : 001248 ( PubMed/Checkpoint ); précédent : 001247; suivant : 001249Atypical antipsychotics and parkinsonism.
Auteurs : Paula A. Rochon [Canada] ; Therese A. Stukel ; Kathy Sykora ; Sudeep Gill ; Susan Garfinkel ; Geoffrey M. Anderson ; Sharon-Lise T. Normand ; Muhammad Mamdani ; Philip E. Lee ; Ping Li ; Susan E. Bronskill ; Connie Marras ; Jerry H. GurwitzSource :
- Archives of internal medicine [ 0003-9926 ] ; 2005.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Antipsychotic Agents (administration & dosage), Antipsychotic Agents (adverse effects), Confidence Intervals, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Odds Ratio, Parkinson Disease, Secondary (chemically induced), Proportional Hazards Models, Retrospective Studies, Risk Factors.
- MESH :
- chemical , administration & dosage : Antipsychotic Agents.
- chemical , adverse effects : Antipsychotic Agents.
- chemically induced : Parkinson Disease, Secondary.
- Aged, Aged, 80 and over, Confidence Intervals, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Odds Ratio, Proportional Hazards Models, Retrospective Studies, Risk Factors.
Abstract
Atypical antipsychotic agents are thought to be less likely than older typical agents to produce parkinsonism. This has not been well documented. We compared the risk of development of incident parkinsonism among older adults dispensed atypical relative to typical antipsychotics.
DOI: 10.1001/archinte.165.16.1882
PubMed: 16157833
Affiliations:
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Rochon</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. paula.rochon@utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Stukel, Therese A" sort="Stukel, Therese A" uniqKey="Stukel T" first="Therese A" last="Stukel">Therese A. 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Normand</name></author><author><name sortKey="Mamdani, Muhammad" sort="Mamdani, Muhammad" uniqKey="Mamdani M" first="Muhammad" last="Mamdani">Muhammad Mamdani</name></author><author><name sortKey="Lee, Philip E" sort="Lee, Philip E" uniqKey="Lee P" first="Philip E" last="Lee">Philip E. Lee</name></author><author><name sortKey="Li, Ping" sort="Li, Ping" uniqKey="Li P" first="Ping" last="Li">Ping Li</name></author><author><name sortKey="Bronskill, Susan E" sort="Bronskill, Susan E" uniqKey="Bronskill S" first="Susan E" last="Bronskill">Susan E. Bronskill</name></author><author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name></author><author><name sortKey="Gurwitz, Jerry H" sort="Gurwitz, Jerry H" uniqKey="Gurwitz J" first="Jerry H" last="Gurwitz">Jerry H. 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Rochon</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. paula.rochon@utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Stukel, Therese A" sort="Stukel, Therese A" uniqKey="Stukel T" first="Therese A" last="Stukel">Therese A. Stukel</name></author><author><name sortKey="Sykora, Kathy" sort="Sykora, Kathy" uniqKey="Sykora K" first="Kathy" last="Sykora">Kathy Sykora</name></author><author><name sortKey="Gill, Sudeep" sort="Gill, Sudeep" uniqKey="Gill S" first="Sudeep" last="Gill">Sudeep Gill</name></author><author><name sortKey="Garfinkel, Susan" sort="Garfinkel, Susan" uniqKey="Garfinkel S" first="Susan" last="Garfinkel">Susan Garfinkel</name></author><author><name sortKey="Anderson, Geoffrey M" sort="Anderson, Geoffrey M" uniqKey="Anderson G" first="Geoffrey M" last="Anderson">Geoffrey M. Anderson</name></author><author><name sortKey="Normand, Sharon Lise T" sort="Normand, Sharon Lise T" uniqKey="Normand S" first="Sharon-Lise T" last="Normand">Sharon-Lise T. Normand</name></author><author><name sortKey="Mamdani, Muhammad" sort="Mamdani, Muhammad" uniqKey="Mamdani M" first="Muhammad" last="Mamdani">Muhammad Mamdani</name></author><author><name sortKey="Lee, Philip E" sort="Lee, Philip E" uniqKey="Lee P" first="Philip E" last="Lee">Philip E. Lee</name></author><author><name sortKey="Li, Ping" sort="Li, Ping" uniqKey="Li P" first="Ping" last="Li">Ping Li</name></author><author><name sortKey="Bronskill, Susan E" sort="Bronskill, Susan E" uniqKey="Bronskill S" first="Susan E" last="Bronskill">Susan E. Bronskill</name></author><author><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name></author><author><name sortKey="Gurwitz, Jerry H" sort="Gurwitz, Jerry H" uniqKey="Gurwitz J" first="Jerry H" last="Gurwitz">Jerry H. Gurwitz</name></author></analytic><series><title level="j">Archives of internal medicine</title><idno type="ISSN">0003-9926</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Antipsychotic Agents (administration & dosage)</term><term>Antipsychotic Agents (adverse effects)</term><term>Confidence Intervals</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Odds Ratio</term><term>Parkinson Disease, Secondary (chemically induced)</term><term>Proportional Hazards Models</term><term>Retrospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Parkinson Disease, Secondary</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Confidence Intervals</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Odds Ratio</term><term>Proportional Hazards Models</term><term>Retrospective Studies</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Atypical antipsychotic agents are thought to be less likely than older typical agents to produce parkinsonism. This has not been well documented. We compared the risk of development of incident parkinsonism among older adults dispensed atypical relative to typical antipsychotics.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16157833</PMID><DateCreated><Year>2005</Year><Month>09</Month><Day>13</Day></DateCreated><DateCompleted><Year>2005</Year><Month>10</Month><Day>13</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-9926</ISSN><JournalIssue CitedMedium="Print"><Volume>165</Volume><Issue>16</Issue><PubDate><Year>2005</Year><Month>Sep</Month><Day>12</Day></PubDate></JournalIssue><Title>Archives of internal medicine</Title><ISOAbbreviation>Arch. Intern. Med.</ISOAbbreviation></Journal><ArticleTitle>Atypical antipsychotics and parkinsonism.</ArticleTitle><Pagination><MedlinePgn>1882-8</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Atypical antipsychotic agents are thought to be less likely than older typical agents to produce parkinsonism. This has not been well documented. We compared the risk of development of incident parkinsonism among older adults dispensed atypical relative to typical antipsychotics.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Retrospective cohort study of all adults 66 years and older in Ontario. We used Cox proportional hazards models to study the association between the type, potency, and dose of antipsychotic dispensed and the development of parkinsonism during 1 year of follow-up.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">All 25,769 older adults prescribed antipsychotics were observed for 11,573 person-years, and 449 events of parkinsonism were identified. Relative to individuals dispensed an atypical antipsychotic, those dispensed a typical agent were 30% more likely (adjusted hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.04-1.58) and those exposed to neither agent were 60% less likely (HR, 0.40; 95% CI, 0.29-0.43) to experience development of parkinsonism. Furthermore, those dispensed lower-potency typical agents were no different (HR, 0.75; 95% CI, 0.48-1.15), and those dispensed higher-potency typical antipsychotics were at close to a 50% greater risk (HR, 1.44; 95% CI, 1.13-1.84) of development of parkinsonism relative to atypical antipsychotics. Relative to those dispensed a high-dose atypical antipsychotic, those dispensed a typical antipsychotic were at similar risk for parkinsonism (Wald chi(2) = 0.14, P = .7).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The risk of development of parkinsonism associated with the use of high-dose atypical antipsychotics was similar to that associated with the use of typical antipsychotics. Caution should be used when prescribing atypical antipsychotic therapy at high doses.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rochon</LastName><ForeName>Paula A</ForeName><Initials>PA</Initials><AffiliationInfo><Affiliation>Institute for Clinical Evaluative Sciences, Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. paula.rochon@utoronto.ca</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stukel</LastName><ForeName>Therese A</ForeName><Initials>TA</Initials></Author><Author ValidYN="Y"><LastName>Sykora</LastName><ForeName>Kathy</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Gill</LastName><ForeName>Sudeep</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Garfinkel</LastName><ForeName>Susan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Anderson</LastName><ForeName>Geoffrey M</ForeName><Initials>GM</Initials></Author><Author ValidYN="Y"><LastName>Normand</LastName><ForeName>Sharon-Lise T</ForeName><Initials>SL</Initials></Author><Author ValidYN="Y"><LastName>Mamdani</LastName><ForeName>Muhammad</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Philip E</ForeName><Initials>PE</Initials></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Ping</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Bronskill</LastName><ForeName>Susan E</ForeName><Initials>SE</Initials></Author><Author ValidYN="Y"><LastName>Marras</LastName><ForeName>Connie</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Gurwitz</LastName><ForeName>Jerry H</ForeName><Initials>JH</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Arch Intern Med</MedlineTA><NlmUniqueID>0372440</NlmUniqueID><ISSNLinking>0003-9926</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Arch Intern Med. 2006 Mar 13;166(5):586; author reply 586-7</RefSource><PMID Version="1">16534048</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016001" MajorTopicYN="N">Confidence Intervals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004305" MajorTopicYN="N">Dose-Response Relationship, Drug</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010302" MajorTopicYN="N">Parkinson Disease, Secondary</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2005</Year><Month>9</Month><Day>15</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2005</Year><Month>10</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2005</Year><Month>9</Month><Day>15</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16157833</ArticleId><ArticleId IdType="pii">165/16/1882</ArticleId><ArticleId IdType="doi">10.1001/archinte.165.16.1882</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Anderson, Geoffrey M" sort="Anderson, Geoffrey M" uniqKey="Anderson G" first="Geoffrey M" last="Anderson">Geoffrey M. Anderson</name><name sortKey="Bronskill, Susan E" sort="Bronskill, Susan E" uniqKey="Bronskill S" first="Susan E" last="Bronskill">Susan E. Bronskill</name><name sortKey="Garfinkel, Susan" sort="Garfinkel, Susan" uniqKey="Garfinkel S" first="Susan" last="Garfinkel">Susan Garfinkel</name><name sortKey="Gill, Sudeep" sort="Gill, Sudeep" uniqKey="Gill S" first="Sudeep" last="Gill">Sudeep Gill</name><name sortKey="Gurwitz, Jerry H" sort="Gurwitz, Jerry H" uniqKey="Gurwitz J" first="Jerry H" last="Gurwitz">Jerry H. Gurwitz</name><name sortKey="Lee, Philip E" sort="Lee, Philip E" uniqKey="Lee P" first="Philip E" last="Lee">Philip E. Lee</name><name sortKey="Li, Ping" sort="Li, Ping" uniqKey="Li P" first="Ping" last="Li">Ping Li</name><name sortKey="Mamdani, Muhammad" sort="Mamdani, Muhammad" uniqKey="Mamdani M" first="Muhammad" last="Mamdani">Muhammad Mamdani</name><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><name sortKey="Normand, Sharon Lise T" sort="Normand, Sharon Lise T" uniqKey="Normand S" first="Sharon-Lise T" last="Normand">Sharon-Lise T. Normand</name><name sortKey="Stukel, Therese A" sort="Stukel, Therese A" uniqKey="Stukel T" first="Therese A" last="Stukel">Therese A. Stukel</name><name sortKey="Sykora, Kathy" sort="Sykora, Kathy" uniqKey="Sykora K" first="Kathy" last="Sykora">Kathy Sykora</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A" last="Rochon">Paula A. 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