Women's College Research Institute

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Older men at greater risk of serious events after starting antipsychotic drugs

February 2013

Dr. 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 (WCRI), conducted a new study investigating the risk of a serious event (hospitalization or death) following the initiation of antipsychotic therapy. 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 Rochon, who is also a professor in the Department of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.

“We began this study comparing women and men with certain expectations, and we ended up gaining some important insights into both women’s and men’s health,” says Rochon.

Rochon’s team found that antipsychotic drug therapy – commonly prescribed to manage the symptoms of dementia – was 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 Ontarians (13,760 women and 7,766 men) with dementia who were newly started on an oral atypical antipsychotic therapy between April 1, 2007 and March 1, 2010. Published in the Journal of the American Geriatric Society (JAGS), the study found that:

  • A serious event occurred in 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.
  • Men were almost 50 per cent more likely to be hospitalized or die.
  • In both women and men, risk of a serious event was related to drug dose.

The researchers controlled for factors including their setting of care, age distribution, comorbidity or drug dose. In each case, men were significantly more likely than women to experience a serious event when newly prescribed antipsychotic therapies.

“Since older women outnumber older men in the population, while the rate of the serious events like such as death was higher among men, many more women than men experienced a serious event,” says Rochon.

“It’s critical that physicians be cautious when prescribing antipsychotic therapy in both older men and older women,” she says.

View JAGS article

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