Risk of hospitalization for acute pancreatitis associated with conventional and atypical antipsychotics: a population-based case-control study.

STUDY OBJECTIVE

To examine the association of atypical and conventional antipsychotics with the risk of hospitalization for acute pancreatitis.

DESIGN

Population-based, case-control study.

DATA SOURCE

Health care databases of Northern Denmark.

PATIENTS

A total of 3083 adults hospitalized with acute pancreatitis (case patients) and 30,830 control subjects.

MEASUREMENTS AND MAIN RESULTS

Controls were selected from the general population by using risk-set sampling and were matched to case patients by age and sex. The date of the case patients' admission for acute pancreatitis was used as the index date for the matched control subjects. Conditional logistic regression analysis was used to estimate rate ratios (RRs) for hospitalization due to acute pancreatitis in current users (0-90 days before admission or index date) and former users (> 90 days before admission or index date) of atypical and conventional antipsychotics compared with nonusers of the respective antipsychotics, while controlling for covariates and stratifying by age. Fifteen case patients (0.5%) were current users of atypical antipsychotics, and 128 case patients (4.2%) were current users of conventional antipsychotics. Adjusted RRs for current use and former use of atypical antipsychotics were 0.6 (95% confidence interval [CI] 0.3-1.1) and 0.3 (95% CI 0.1-0.9), respectively. A trend was noted for increasing risk of hospitalization due to acute pancreatitis with decreasing potency of conventional antipsychotics, with adjusted RRs of 1.2 (95% CI 0.7-2.0) for high-potency, 1.5 (95% CI 1.0-2.2) for intermediate-potency, and 2.8 (95% CI 2.0-3.8) for low-potency conventional antipsychotics, which was largely age-modified with an adjusted RR of 5.2 (95% CI 3.2-8.5) in patients younger than 60 years, compared with an adjusted RR of 1.5 (95% CI 0.9-2.5) in older users. Former use of conventional antipsychotics of any kind was associated with an adjusted RR of 1.6 (95% CI 1.4-1.9).

CONCLUSIONS

Current use of low-potency conventional, but not atypical, antipsychotics was associated with an increased risk of hospitalization for acute pancreatitis.