Antipsychotic drugs increase risk of developing pneumonia in elderly

Elderly patients who use antipsychotic drugs have a 60 percent increased risk of developing pneumonia compared to non-users.

This risk is highest in the first week following prescription and decreases gradually thereafter. These findings are published in Journal of the American Geriatrics Society.

Antipsychotic drugs are frequently used in elderly patients for the treatment of psychosis and behavioral problems associated with dementia and delirium. This study is the first to show that the development of pneumonia is associated with antipsychotic drug use.

“The risk of developing pneumonia is not associated with long-term use, but is the highest shortly after starting the drug,” say Drs. Rob van Marum and Wilma Knol, authors of the study. They caution that “all antipsychotic drugs may be associated with pneumonia in elderly patients.”

In nursing homes, up to 40 percent of residents may be prescribed antipsychotics, according to the study. It has been suggested that, for residents of nursing homes who receive antipsychotic therapy, more than half are prescribed for inappropriate reasons.

Although literature shows limited efficacy and effectiveness for antipsychotic drug use in the treatment of behavioral problems in dementia patients, these drugs are frequently used for this purpose. In the last few years it has become clear that the use of antipsychotic drugs in elderly patients is also associated with an increased risk of death and morbidity.

The underlying mechanism for the association remains unclear. The authors stress that clinicians may need to monitor patients for sedation after initiation of antipsychotic medication and that a careful weighing of the possible risks is recommended before starting antipsychotic treatment in elderly people.