Somnolence effects of antipsychotic medications and the risk of unintentional injury

Somnolence effects of antipsychotic medications and the risk of unintentional injury Purpose This study examined the relationship between antipsychotic medications, categorized by published somnolence effects, and unintentional injury (UI). Methods The study population included patients of 18–64 years of age in a healthcare insurance database with claims from 2001 to 2004 and diagnoses of schizophrenia or affective disorder. A nested case‐control design was used with cases defined by an E‐code claim (a specified external cause of injury) for selected UIs. For cases, the index date referred to the first injury. For controls, the “control index date” was the date of claim if there was only a single medical claim; for patients with ≥2 claims, one was selected at random as the “control index date.” Both groups had a prescription for a first‐generation antipsychotic (FGA) or second‐generation antipsychotic (SGA) overlapping the index date. Potential somnolence effects were defined as: low (referent) – aripiprazole/ziprasidone; medium – risperidone; high – olanzapine/quetiapine: or any single FGA. Logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI) for UI, adjusted for gender, age, concomitant drug, and psychiatric diagnosis. Results Among 648 cases and 5214 controls, high‐somnolence SGAs were associated with an OR of 1.41 95%CI (1.03–1.93) for risk of UI, while medium‐somnolence SGAs, and FGAs had ORs of 1.17 95%CI (0.83–1.64) and 1.17 95%CI (0.79–1.74), respectively. When quetiapine and olanzapine were disaggregated, ORs were 1.61 95%CI (1.15–2.25) and 1.25 95%CI (0.89–1.74), respectively. Conclusions High‐somnolence SGAs may lead to UI among patients. When prescribing antipsychotics, clinicians should consider potential somnolence. Copyright © 2008 John Wiley & Sons, Ltd. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pharmacoepidemiology and Drug Safety Wiley

Somnolence effects of antipsychotic medications and the risk of unintentional injury

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Publisher
Wiley
Copyright
Copyright © 2008 John Wiley & Sons, Ltd.
ISSN
1053-8569
eISSN
1099-1557
D.O.I.
10.1002/pds.1559
Publisher site
See Article on Publisher Site

Abstract

Purpose This study examined the relationship between antipsychotic medications, categorized by published somnolence effects, and unintentional injury (UI). Methods The study population included patients of 18–64 years of age in a healthcare insurance database with claims from 2001 to 2004 and diagnoses of schizophrenia or affective disorder. A nested case‐control design was used with cases defined by an E‐code claim (a specified external cause of injury) for selected UIs. For cases, the index date referred to the first injury. For controls, the “control index date” was the date of claim if there was only a single medical claim; for patients with ≥2 claims, one was selected at random as the “control index date.” Both groups had a prescription for a first‐generation antipsychotic (FGA) or second‐generation antipsychotic (SGA) overlapping the index date. Potential somnolence effects were defined as: low (referent) – aripiprazole/ziprasidone; medium – risperidone; high – olanzapine/quetiapine: or any single FGA. Logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI) for UI, adjusted for gender, age, concomitant drug, and psychiatric diagnosis. Results Among 648 cases and 5214 controls, high‐somnolence SGAs were associated with an OR of 1.41 95%CI (1.03–1.93) for risk of UI, while medium‐somnolence SGAs, and FGAs had ORs of 1.17 95%CI (0.83–1.64) and 1.17 95%CI (0.79–1.74), respectively. When quetiapine and olanzapine were disaggregated, ORs were 1.61 95%CI (1.15–2.25) and 1.25 95%CI (0.89–1.74), respectively. Conclusions High‐somnolence SGAs may lead to UI among patients. When prescribing antipsychotics, clinicians should consider potential somnolence. Copyright © 2008 John Wiley & Sons, Ltd.

Journal

Pharmacoepidemiology and Drug SafetyWiley

Published: Apr 1, 2008

References

  • New atypical antipsychotic medications
    Jibson, Jibson; Tandon, Tandon
  • Drugs and falls in community‐dwelling older people: a national veterans study
    French, French; Campbell, Campbell; Spehar, Spehar; Cunningham, Cunningham; Bulat, Bulat; Luther, Luther
  • Atypical antipsychotic medications and risk of falls in residents of aged care facilities
    Hien le, Hien le; Cumming, Cumming; Cameron, Cameron
  • Psychoactive substance use and the risk of motor vehicle accidents
    Movig, Movig; Mathijssen, Mathijssen; Nagel, Nagel

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