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Mortality Risk Up With Newer Antipsychotic Use for Depression

Risk up for nonelderly adults with augmentation with newer antipsychotic versus second antidepressant

FRIDAY, Oct. 2, 2020 (HealthDay News) — For nonelderly patients with depression, augmentation with newer antipsychotics is associated with an increased mortality risk, according to a study published online Sept. 30 in PLOS ONE.

Tobias Gerhard, Ph.D., from Rutgers University in New Brunswick, New Jersey, and colleagues examined all-cause mortality of newer antipsychotic augmentation for adult depression in nonelderly adults (aged 25 to 64 years). Participants in the cohort study initiated augmentation with either a newer antipsychotic (22,410 patients) or with a second antidepressant (17,172 patients) after three or more months of antidepressant monotherapy.

The researchers found that during 13,328 person-years of follow-up, 153 patients died (newer antipsychotic augmentation: mortality rate, 138.1/10,000 person-years; antidepressant augmentation: mortality rate, 83.8/10,000 person-years). The adjusted hazard ratio was 1.45, indicating an increased risk for all-cause mortality with newer antipsychotic augmentation versus antidepressant augmentation (risk difference, 37.7 per 10,000 person-years).

“Our results require replication, ideally with a publicly financed pragmatic randomized controlled trial,” Gerhard said in a statement. “However, in the meantime, our study suggests that physicians should consider prescribing antipsychotics to adults with depression carefully, as the potential health risks are substantial and the benefits are quite modest and controversially debated.”

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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