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Response to guidance on use of olanzapine and risperidone: a community-based study of primary and secondary care

  • Karen L. Franks (a1)
Abstract
Aims and Method

The aim of the study was to assess the response to the guidance from the Committee on Safety of Medicines (CSM) on prescribing olanzapine and risperidone for older adults. Information on 96 older patients who were prescribed olanzapine or risperidone was gathered from psychiatric case notes, general practitioners and care homes. Data were gathered 10 weeks after the CSM guidance (Time 1) and again 6 months later (Time 2).

Results

At Time 1, 71 out of 96 patients (74%) had been reviewed and 90 (94%) by Time 2. By 6 months after the guidance 34 of 52 patients with dementia (65%) and 10 of 35 patients with functional diagnoses had been withdrawn from medication; 29% (14/49) of those withdrawn from medication had significant problems associated with withdrawal. In many cases medication was continued following risk–benefit decisions taken at review and despite CSM guidance.

Clinical Implications

Guidance has prompted review of prescribing in existing patients and some re-referrals, which has increased workload. The guidance has changed the management of existing patients, but there has been a high rate of associated clinical problems and numerous patients remain on, or return to, olanzapine or risperidone.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Committee on Safety of Medicines (2004) Message Sent to Healthcare Professionals. http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary=true&SSDocName=CON1004298&ssTargetNodeld=221
Finkel, S., Kozma, C., Long, S., et al (2005) Risperidone treatment in elderly patients with dementia: relative risk of cerebrovascular events versus other antipsychotics. International Psychogeriatrics, 17, 617629.
Gill, S. S., Rochon, P. A., Herrmann, N., et al (2005) Atypical antipsychotic drugs and risk of ischaemic stroke: population based retrospective cohort study. BMJ, 330, 445.
Herrmann, N. & Lanctot, K. L. (2005) Do atypical antipsychotics cause stroke? CNS Drugs, 19, 91103.
Herrmann, N., Madami, M. & Lanctot, K. L. (2004) Atypical antipsychotics and risk of cerebrovascular accidents. American Journal of Psychiatry, 161, 11131115.
Liperoti, R., Gambassi, G., Lapane, K. L., et al (2005) Cerebrovascular events among elderly nursing home patients treated with conventional or atypical antipsychotics. Journal of Clinical Psychiatry, 66, 10901096.
Moretti, R., Torre, P., Antonello, R. M., et al (2005) Olanzapine as a possible treatment of behavioural symptoms in vascular dementia: risks of cerebrovascular events. A controlled open-label study. Journal of Neurology, 252, 11861193.
Mowat, D., Fowlie, D. & MacEwan, T. (2004) CSM warning on atypical antipsychotics and stroke may be detrimental for dementia. BMJ, 328, 1262.
Percudani, M., Barbui, C., Fortino, I., et al (2005) Second-generation antipsychotics and risk of cerebrovascular accidents in the elderly. Journal of Clinical Psychopharmacology, 25, 468470.
Royal College of Psychiatrists Faculty for the Psychiatry of Old Age (2004) Atypical Antipsychotics and Behavioural and Psychiatric Symptoms of Dementia. Prescribing Update for Old Age Psychiatrists. http://www.rcpsych.ac.uk/pdf/Atypicalguidance.pdf
Schneider, L. S., Dagerman, K. S. & Insel, P. (2005) Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomised placebo-controlled trials. JAMA, 294, 19341935.
Suh, G. H. & Shah, A. (2005) Effect of antipsychotics on mortality in elderly patients with dementia: a 1-year prospective study in a nursing home. International Psychogeriatrics, 17, 429441.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Response to guidance on use of olanzapine and risperidone: a community-based study of primary and secondary care

  • Karen L. Franks (a1)
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