Abstract

PURPOSE
Long-term persistence of use, lack of co-prescribed anticholinergic antiparkinson drugs and low mortality may indicate effectiveness and safety of antipsychotic drugs. We aimed to assess 3-year prescription persistence, concomitant use of anticholinergics and mortality related to the use of all antipsychotic agents available in Norway.
METHODS
Data were drawn from the Norwegian Prescription Database on the sales of antipsychotic and anticholinergic antiparkinson agents in 2004 to a total of 52,427 patients. The primary study group was a subgroup of 34,494 patients who were prescribed only one antipsychotic agent in 2004. The patients were re-investigated in 2007. For each of the 13 antipsychotic agents studied, assumed prescription persistence was assessed in light of use of anticholinergic antiparkinson agents in 2004, and casualty rates were noted.
RESULTS
The highest persistence was demonstrated for zuclopenthixol (69.8%) and clozapine (88.4%). Zuclopenthixol was often co-prescribed with anticholinergics (22.2%), in contrast to clozapine (3.6%). Ziprasidone was associated with a low mortality (OR = 0.08), while chlorprotixene and haloperidol were associated with a high mortality (OR = 1.34 and 3.97, respectively) compared to levomepromazine.
CONCLUSIONS
Clozapine demonstrated a high degree of continuity of prescription and a low level of concomitant use of anticholinergics. Zuclopenthixol also demonstrated a high degree of continuity of prescription, despite a considerable degree of co-prescribed anticholinergics. We did not find that any antipsychotic other than ziprasidone was associated with a low mortality. The use of haloperidol seemed to confer a mortality risk three times that of any of the other antipsychotic agents included.

Links

Publisher Full Text

Authors

Gjerden P, Slørdal L, Bramness JG

Institution

Department of Psychiatry, Telemark Hospital, Skien, Norway. pal.gjerden@sthf.no

Source

European journal of clinical pharmacology 66:9 2010 Sep pg 911-7

MeSH

Adult
Aged
Antiparkinson Agents
Antipsychotic Agents
Chlorprothixene
Cholinergic Antagonists
Clopenthixol
Clozapine
Drug Prescriptions
Female
Follow-Up Studies
Haloperidol
Humans
Logistic Models
Male
Methotrimeprazine
Middle Aged
Mortality
Norway
Odds Ratio
Piperazines
Registries
Thiazoles

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20521034