ArticleBMJ (Clinical research ed.)2024
Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study.
Article in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 5 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed, 5 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Multiple Adverse Outcomes Associated with Risperidone in People with Dementia: An Individual Participant Data Meta-Analysis.CNS drugs · 2026Pooled it
- Efficacy and Safety of Cannabinoids for Neuropsychiatric Symptoms of Dementia: A Systematic Review with Meta-analysis.CNS drugs · 2026Pooled it
- The consequences of antipsychotic medication use for people living with dementia: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Pooled it
- Rapid Review of Interventions Designed to Enhance Personalised Care for People With Dementia When There Are Concerns About Reduced Awareness of Difficulties.International journal of geriatric psychiatry · 2025Pooled it
- Standardizing care for agitation in Alzheimer's disease, results from a randomized controlled trial of an integrated care pathway versus usual care - the StaN trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Trial
- Trial
- Antipsychotic Drug Interactions and Short-Term Mortality Risk in People With Dementia: A National Cohort Study.Clinical pharmacology and therapeutics · 2026Article
- Anti-psychotic therapeutics modify gut microbial metabolism and modulate susceptibility to gastrointestinal infection in mice.bioRxiv : the preprint server for biology · 2026Article
- Individualized Medication Selection and Outcome Prediction for Patients With Dementia and BPSD Based on Systemic Immune-Inflammation Index (SII): A Retrospective Case-Control Study.Actas espanolas de psiquiatria · 2026Article
- Does the drug accelerate the decline, or the decline invite the drug? Reverse causation in studies of inappropriate medications and dementia progression.European journal of clinical pharmacology · 2026Article
- Stroke Heart Syndrome: Neuroimmune and Metabolic Crosstalk with Conceptual Approaches for Precision Therapeutics.Cardiovascular drugs and therapy · 2026Review
- Observational
- Developing a Novel Digital Tool for Personalised Antipsychotic Prescribing in People Living With Dementia: The Views of Australian Clinicians.Dementia (London, England) · 2026Article
- Prediction of Antipsychotic Drug Doses for BPSD in Alzheimer's Disease Using Deep Learning Techniques.Diagnostics (Basel, Switzerland) · 2026Article
- The economics of decision-making in dementia care and related life-limiting illness: a narrative review.Health economics review · 2026Review
- Article
- Severe hypotension following sublingual dexmedetomidine administration in an elderly patient.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026Article
- Patterns of psychotropic drug dispensation in Portugal amidst the COVID-19 pandemic and beyond.Scientific reports · 2026Article
- Association Between State Essential Caregiver Programs and Antipsychotic Medication Use Rate in Nursing Homes During the COVID-19 Pandemic.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate risks of multiple adverse outcomes associated with use of antipsychotics in people with dementia.
designPopulation based matched cohort study.
settingLinked primary care, hospital and mortality data from Clinical Practice Research Datalink (CPRD), England. POPULATION: Adults (≥50 years) with a diagnosis of dementia between 1 January 1998 and 31 May 2018 (n=173 910, 63.0% women). Each new antipsychotic user (n=35 339, 62.5% women) was matched with up to 15 non-users using incidence density sampling.
main outcome measuresThe main outcomes were stroke, venous thromboembolism, myocardial infarction, heart failure, ventricular arrhythmia, fracture, pneumonia, and acute kidney injury, stratified by periods of antipsychotic use, with absolute risks calculated using cumulative incidence in antipsychotic users versus matched comparators. An unrelated (negative control) outcome of appendicitis and cholecystitis combined was also investigated to detect potential unmeasured confounding.
resultsCompared with non-use, any antipsychotic use was associated with increased risks of all outcomes, except ventricular arrhythmia. Current use (90 days after a prescription) was associated with elevated risks of pneumonia (hazard ratio 2.19, 95% confidence interval (CI) 2.10 to 2.28), acute kidney injury (1.72, 1.61 to 1.84), venous thromboembolism (1.62, 1.46 to 1.80), stroke (1.61, 1.52 to 1.71), fracture (1.43, 1.35 to 1.52), myocardial infarction (1.28, 1.15 to 1.42), and heart failure (1.27, 1.18 to 1.37). No increased risks were observed for the negative control outcome (appendicitis and cholecystitis). In the 90 days after drug initiation, the cumulative incidence of pneumonia among antipsychotic users was 4.48% (4.26% to 4.71%) versus 1.49% (1.45% to 1.53%) in the matched cohort of non-users (difference 2.99%, 95% CI 2.77% to 3.22%).
conclusionsAntipsychotic use compared with non-use in adults with dementia was associated with increased risks of stroke, venous thromboembolism, myocardial infarction, heart failure, fracture, pneumonia, and acute kidney injury, but not ventricular arrhythmia. The range of adverse outcomes was wider than previously highlighted in regulatory alerts, with the highest risks soon after initiation of treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.