Ralph Stephen J, Espinet Anthony J
School of Medical Science, Griffith University, Gold Coast, Southport, QLD, Australia.
School of Medicine, Griffith University, Gold Coast, Southport, QLD, Australia.
J Alzheimers Dis Rep. 2018 Feb 2;2(1):1-26. doi: 10.3233/ADR-170042.
It is almost ten years since the Banerjee 2009 report established that inappropriate prescribing of antipsychotics in the elderly was occurring in the UK and such patients had an 85% increased risk of adverse events and greater mortality. This report was a critical analysis addressing the outcomes of treatment practices for dementia in UK patients and globally, aimed at reducing prescribing of antipsychotic drugs for dementia. Since 2009, many significant studies worldwide (including several more recent large retrospective studies) provide more extensive longitudinal data for the adverse impacts of antipsychotic drugs in dementia. We have used the data in these studies including from over 380,000 dementia patients, with 85,069 prescribed antipsychotic agents as well as from 359,235 non-dementia antipsychotic drug users to provide an up-dated meta-analysis. This is the first meta-analysis to include evidence from general mental health studies showing that antipsychotic drugs precipitate excessive mortality across the spectrum. Prescribing of antipsychotic drugs for dementia or for other mental health care should be avoided and alternative means sought for handling behavioral disorders of such patients.
自2009年班纳吉报告指出英国存在老年人抗精神病药物处方不当的情况，且此类患者不良事件风险增加85%、死亡率更高以来，已过去近十年。该报告是一项针对英国及全球痴呆症治疗实践结果的批判性分析，旨在减少用于痴呆症的抗精神病药物的处方。自2009年以来，全球许多重要研究（包括几项近期的大型回顾性研究）提供了关于抗精神病药物对痴呆症不良影响的更广泛纵向数据。我们利用了这些研究中的数据，包括来自超过38万名痴呆症患者（其中85069人开具了抗精神病药物）以及359235名非痴呆症抗精神病药物使用者的数据，进行了一项更新的荟萃分析。这是第一项纳入普通心理健康研究证据的荟萃分析，表明抗精神病药物会导致全范围内的过高死亡率。应避免为痴呆症或其他精神卫生保健开具抗精神病药物，应寻求其他方法来处理此类患者的行为障碍。
