Second-generation (atypical) antipsychotic drugs may not have an advantage for cardiovascular risk over typical antipsychotics, according to a recent, large retrospective cohort study. Researchers at the Vanderbilt University School of Medicine in Tennessee found that risk of sudden cardiac death is heightened with antipsychotics, whether typical or atypical, and the risk increases significantly with increasing doses.
In a recent issue of the New England Journal of Medicine, lead investigator Wayne Ray, PhD, and colleagues,1 report that while a favorable extrapyramidal adverse–effect profile has led many to consider atypical antipsychotics safer than typical antipsychotics for cardiac risk, “the atypical antipsychotic drugs are no safer than the older drugs.”
The study was designed to detect an increased incidence of sudden cardiac death in patients treated with antipsychotics. The researchers identified new users of the study drugs and established the temporal relationship between patient characteristics before treatment and outcomes after treatment initiation. They analyzed data from 44,218 patients treated with a typical antipsychotic, 46,089 patients treated with an atypical antipsychotic, and 186,600 matched nonusers. The participants’ mean age was 45.7 years. The analysis controlled for an array of cardiovascular disease variables.
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