Antipsychotic drugs used to treat Alzheimer’s disease (AD) symptoms are associated with an increased risk of pneumonia in patients, according to the results of new study from the University of Eastern Finland. The risk of pneumonia was the highest at the start of antipsychotic treatment, and remained high in long-term use.
The study, “Antipsychotic use and risk of hospitalisation or death due to pneumonia in persons with and without Alzheimer’s disease,” was published in the journal Chest.
Antipsychotic use is already associated with an increased risk for developing pneumonia, and people with dementia are also known to be particularly susceptible to it. Still, only one small study has assessed the risk of pneumonia in relation to antipsychotic use among Alzheimer’s patients.
The fact that nearly one-third of Finns with AD use antipsychotic drugs prompted Anna-Maija Tolppanen and her colleagues to examine if such use is tied to a higher risk of hospitalization or death due to pneumonia. For their analysis, the researchers used data from MEDALZ, a Finnish nationwide register-based cohort study (2005–12) comprising 60,584 patients with a clinically verified diagnosis of Alzheimer’s. Of these, 12,225 patients had incident pneumonia.
Researchers excluded from their analysis those patients who had used antipsychotic medication or had pneumonia within one year of their investigation, as well as those who had a diagnosis of schizophrenia and bipolar disorder. They then compared results with a matched cohort of people being treated with antipsychotics who did not have AD.
They found that the age-adjusted pneumonia incidence during antipsychotic use periods was similar both in AD patients and in those without AD. Antipsychotic use was associated with higher pneumonia risk in patients with AD, and a somewhat higher risk in those without AD.
The three most commonly used antipsychotics (quetiapine, risperidone, haloperidol) had similar associations with pneumonia risk, the researchers found.
“Regardless of applied study design, treatment duration, or the choice of drug, antipsychotic use was associated with higher risk of pneumonia. With observational data we cannot fully rule out a shared causality between pneumonia and antipsychotic use, but the risk-benefit balance should be considered when antipsychotics are prescribed,” the researchers concluded.