Mental Health Rx Posed Physical Health Risks

Atypical antipsychotic medications may pose increased risk of falls and fractures to the elderly

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Older adults taking newer antipsychotic medications may need to be extra wary of bumps and slips.

A new study found that older patients taking atypical antipsychotic medications had an increased risk of falling and bone fractures. Also, hospital visits for falls and fractures went up among this group of patients.

Lisa-Ann Fraser, MD, of the University of Western Ontario in Canada, led this study.

“Although previous results have been mixed, several articles have identified fall and fracture risk as complications of new antipsychotic medication use," Dr. Fraser and team wrote. "Our findings complement these articles and confirm the association."

Dr. Fraser and team studied nearly 200,000 patients who had been prescribed an oral atypical antipsychotic for dementia or behavioral disorders.

Both atypical and typical antipsychotics are used to treat mental health disorders. The difference between the two is that atypical antipsychotics are said to cause fewer side effects and treat symptoms more effectively than their older counterparts.

Atypical antipsychotics have also been found to improve mental function and decrease delusions and hallucinations in patients who don't respond well to typical antipsychotics.

Antipsychotics in this study included quetiapine (brand name Seroquel), risperidone (Risperdal) and olanzapine (Zyprexa).

Why do atypical antipsychotics result in falls and fractures? It might be because these medications have been tied to side effects like orthostatic hypotension (a head rush or dizzy spell where a person’s blood pressure suddenly drops when standing up or stretching), drowsiness and trouble with walking — all of which can make older patients more prone to falling and breaking their bones.

Dr. Fraser and team found that patients prescribed atypical antipsychotics had a higher risk of bone fractures and hospital visits for falls. To be precise, use of a new prescription of an atypical antipsychotic was tied to a 52 percent increased risk of a serious fall and a 50 percent increased risk of a bone fracture.

“In summary, these findings call into question the widespread off-label use of atypical antipsychotic medications and support increasing evidence of safety concerns regarding their use in older adults,” Dr. Fraser and team wrote.

This study was published Jan. 12 in JAMA Internal Medicine.

The Institute for Clinical Evaluative Sciences Western Site, under the Ontario Ministry of Health and Long-Term Care, funded this research. Study author Dr. Amit X. Garg received grants from Astellas, Roche and Pfizer.

Review Date: 
January 11, 2015
Last Updated:
January 13, 2015