Women's College Research Institute

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Older men at greater risk of serious events after starting antipsychotic drug therapy

Story from Connect, January 21, 2013

paula rochonVery little is known about the way older women and men differ in their response to drug therapy. That’s why Dr. Paula Rochon, senior scientist at Women’s College Research Institute conducted a new study investigating the risk of a serious event (hospitalization or death) following the initiation of antipsychotic therapy. Dr. Rochon’s team, which included researchers from WCRI and the Institute for Clinical Evaluative Sciences, found that older men with dementia are more likely to experience a serious event than women in the same age group.

“Understanding how drug therapy affects older women and men differently is important because it can impact the treatment decisions physicians make regarding prescribing drug therapy for their patients,” says Dr. Rochon. “We began this study comparing women and men, and ended up gaining insight into men’s health as well as women’s health.”

Antipsychotic drug therapy has been associated with serious events that can occur shortly after the initiation of the therapy.

The population-based, retrospective cohort study looked at 21,526 older adults (13,760 women and 7,766 men) with dementia newly started on an oral atypical antipsychotic therapy between April 1, 2007 and March 1, 2010 in Ontario and found:

  • nearly nine per cent had a serious event (7.6 per cent of women and 10.9 per cent of men)
  • in the group studied, 2.6 per cent of women and 4.6 per cent of men died
  • relative to women, men were almost 50 per cent more likely to be hospitalized or die
  • men were consistently more likely to experience a serious event based on analyses that considered setting of care, age groups, Charlson comorbidity scores, and antipsychotic dose
  • a gradient of risk by drug dose was found for the development of a serious event in both women and men

“We tested whether our findings of differences between women and men could be explained by factors including their setting of care, age distribution, comorbidity or drug dose,” adds Dr. Rochon.

“In each case, men were significantly more likely than women to experience a serious event, leading us to believe that there are other reasons why older men experience worse outcomes than women when newly prescribed antipsychotic therapies.”

Although the risk of developing a serious event shortly after beginning antipsychotic therapy was higher in older men, the authors stress that physicians be cautious when prescribing antipsychotic therapy in older women as well.

 

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