Older Patients on Psychotropic Medications at Increased Risk of Death During Heat Waves: Presented at APA
- By Ed Susman
NEW ORLEANS — May 25, 2010 — Older patients (>=70 years) who are on antidepressants or antipsychotics have an increased risk of mortality, according to an analysis of deaths during the tragic August 2003 European heat wave, researchers said here at the Annual Meeting of the American Psychiatric Association (APA).
"We believe this study suggests that during heat waves doctors should carefully assess the risk/benefit ratio of psychotropic drug use in older people," said Clementine Norden, MD, Sainte Ann Hospital Center, Paris, France, during a poster presentation on May 24.
"Our findings suggest that a causal relationship may exist between psychotropic drug use during a heat wave and increased risk of death in older people," she said.
Dr. Norden and colleagues analysed the French Social Security Insurance national database records information on reimbursed drugs in about 855 of the French population. In the study, the researchers reviewed data on individuals aged 70 to 100 years who had at least 1 drug refunded in 2003. They identified cases as anyone who died in the August 2003 heat wave and considered controls as individuals alive on April 30, 2004.
The study involved 11,624 cases — 2,093 people who died prior to the heat wave and 9,531 people who died during the heat wave. "We found that older people treated with psychotropic medication are at a greater risk of death during a heat wave," Dr. Norden said. "This risk was particularly increased for antidepressants and antipsychotic drugs."
The researchers calculated that if a person was on at least 1 psychotropic drug during the heat wave, these older individuals had a 30% greater risk of death compared with the similar patients who were taking the drugs before the heat wave (August 1-4) that lasted from August 5 to 13 (P < .05).
The number of psychotropic drugs also mattered, Dr. Norden reported. She said that patients who took more than 1 psychotropic drug also had a 30% increased of death during the heat wave (P < .05).
If an older person was on antidepressants during the heat wave, they had a 70% increased risk of death compared with controls; prior to the heat wave being on an antidepressant increased risk about 20%. Both increases were statistically significant (P < .05).
Dr. Norden said that if an older person was on an antipsychotic, the risk of dying during the heat wave was 2.1 times controls. Even when there was no heat wave, the risk of dying if a person was on an antipsychotic was 50% higher than controls (P < .05).
[Presentation title: Psychotropic Drug Use in Older People and Risk of Death During Heat Waves: A French Population-Based Case-Control Study. Abstract NR7-37]