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Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths
- Source :
- JAMA Psychiatry. 76:162
- Publication Year :
- 2019
- Publisher :
- American Medical Association (AMA), 2019.
-
Abstract
- IMPORTANCE: Children and youths who are prescribed antipsychotic medications have multiple, potentially fatal, dose-related cardiovascular, metabolic, and other adverse events, but whether or not these medications are associated with an increased risk of death is unknown. OBJECTIVE: To compare the risk of unexpected death among children and youths who are beginning treatment with antipsychotic or control medications. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was conducted from 1999 through 2014 and included Medicaid enrollees aged 5 to 24 years in Tennessee who had no diagnosis of severe somatic illness, schizophrenia or related psychoses, or Tourette syndrome or chronic tic disorder. Data analysis was performed from January 1, 2017, to August 15, 2018. EXPOSURES: Current, new antipsychotic medication use at doses higher than 50 mg (higher-dose group) or 50 mg or lower chlorpromazine equivalents (lower-dose group) as well as control medications (ie, attention-deficit/hyperactivity disorder medications, antidepressants, or mood stabilizers) (control group). MAIN OUTCOMES AND MEASURES: Deaths during study follow-up while out of hospital or within 7 days after hospital admission, classified as either deaths due to injury or suicide or unexpected deaths. Secondary outcomes were unexpected deaths not due to overdose and death due to cardiovascular or metabolic causes. RESULTS: This study included 189 361 children and youths in the control group (mean [SD] age, 12.0 [5.1] years; 43.4% female), 28 377 in the lower-dose group (mean [SD] age, 11.7 [4.4] years; 32.3% female), and 30 120 in the higher-dose group (mean [SD] age, 14.5 [4.8] years; 39.2% female). The unadjusted incidence of death in the higher-dose group was 146.2 per 100 000 person-years (40 deaths per 27 354 person-years), which was significantly greater than that in the control group (54.5 per 100 000 population; 67 deaths per 123 005 person-years) (P
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Population
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Attention deficit hyperactivity disorder
Young adult
Child
Antipsychotic
education
Retrospective Studies
Original Investigation
Child Psychiatry
Psychiatry
education.field_of_study
Dose-Response Relationship, Drug
business.industry
Incidence
Incidence (epidemiology)
Case-control study
Retrospective cohort study
medicine.disease
Tennessee
030227 psychiatry
Death
Suicide
Psychiatry and Mental health
Schizophrenia
Case-Control Studies
Child, Preschool
Wounds and Injuries
Female
business
030217 neurology & neurosurgery
Antipsychotic Agents
Subjects
Details
- ISSN :
- 2168622X
- Volume :
- 76
- Database :
- OpenAIRE
- Journal :
- JAMA Psychiatry
- Accession number :
- edsair.doi.dedup.....b8dcfbc8c022b7d0c4d3eae5244ca7aa