17425Acadia Pharmaceuticals Inc., San Diego, CA, USA.
5532Division of Nephrology, Hennepin County Medical Center, Minneapolis, MN, USA.
Am J Alzheimers Dis Other Demen. 2022 Jan-Dec;37:15333175221081374. doi: 10.1177/15333175221081374.
Currently, there are no Food and Drug Administration-approved therapies to treat dementia-related psychosis (DRP). This study investigated the association between using antipsychotics and the anticonvulsant divalproex (sodium valproate) to manage DRP and adverse outcomes.
A retrospective case/control matching study evaluated the risk of mortality, extrapyramidal symptoms (EPS), ischemic stroke, and cardiac arrest/ventricular arrhythmia (CA/VA) with ever-use of antipsychotics/divalproex in patients with DRP vs never-use.
49 509 patients were included; 76.8% used an antipsychotic/divalproex. Treatment ever-use was associated with an increased risk of all-cause mortality (odds ratio, 1.14; 95% CI, 1.10-1.18) and a smaller increase in the risk of EPS (1.10; 1.00-1.19) relative to never-use (adjusted for matching demographic variables, comorbid conditions, and disability)
Current agents used for DRP were associated with increased risk of death and adverse outcomes. An increased risk of death was evident within 3 months of antipsychotic/divalproex initiation and persisted with long-term use.
目前，尚无经美国食品药品监督管理局批准的治疗与痴呆相关的精神病（DRP）的疗法。本研究调查了使用抗精神病药和抗惊厥药丙戊酸钠（valproic acid sodium）来治疗 DRP 和不良结局的关联。
一项回顾性病例/对照匹配研究评估了在患有 DRP 的患者中，与从未使用过相比，使用抗精神病药/丙戊酸钠的患者的死亡率、锥体外系症状（EPS）、缺血性中风和心脏骤停/室性心律失常（CA/VA）的风险。
共纳入 49509 例患者；76.8%的患者使用了抗精神病药/丙戊酸钠。与从未使用过相比，治疗的使用与全因死亡率（比值比，1.14；95%置信区间，1.10-1.18）和 EPS 风险略有增加（1.10；1.00-1.19）相关（调整匹配的人口统计学变量、合并症和残疾）。
目前用于 DRP 的药物与死亡风险和不良结局的风险增加相关。在使用抗精神病药/丙戊酸钠的 3 个月内，死亡风险增加，并且随着长期使用而持续存在。
