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Antiepileptic Drugs May Up Death Risk in Patients With Alzheimer Disease

Mortality risk highest during the first three months of treatment with antiepileptic drugs

FRIDAY, June 5, 2020 (HealthDay News) — Antiepileptic drugs (AEDs) are associated with a higher risk for mortality in patients with Alzheimer disease (AD), according to a study published online May 19 in Neurology.

Tatyana Sarycheva, M.D., from University of Eastern Finland in Kuopio, and colleagues used data from the Medication Use and Alzheimer Disease cohort of all Finnish persons with a clinically verified AD diagnosis (70,718 individuals) from 2005 to 2011 to evaluate the risk for death for those with incident AED use versus nonuse in people with AD.

The researchers found that nearly 50 percent discontinued AEDs within six months. AED users had an increased relative risk for death (inverse probability of treatment weighting [IPTW] hazard ratio [HR], 1.23; 95 percent confidence interval [CI], 1.12 to 1.36) compared with nonusers. This was largely attributable to deaths from dementia (IPTW HR, 1.62; 95 percent CI, 1.42 to 1.86), as there was no difference in cardiovascular and cerebrovascular deaths (IPTW HR, 0.98; 95 percent CI, 0.67 to 1.44). Mortality overall was highest during the first 90 days of AED use (IPTW HR, 2.40; 95 percent CI, 1.91 to 3.03). Compared with users of newer AEDs, the relative risk for death was greater among users of older AEDs (IPTW HR, 1.79; 95 percent CI, 1.52 to 2.16).

“In older vulnerable patients with a cognitive disorder, careful consideration of AED initiation and close adverse events monitoring are needed,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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