Linking Alzheimer's Disease, Antipsychotics, and Pneumonia

For Alzheimer’s disease patients, the risk of pneumonia could be increased with the use of antipsychotic medications, according to findings published in the journal Chest.

The University of Eastern Finland researchers noted that although antipsychotics had been linked to an increased risk of pneumonia in some studies, those studies have rarely been performed with a dementia population. The study authors included approximately 60,000 Alzheimer’s disease patients in their retrospective cohort study to investigate whether antipsychotic medications were related to hospitalizations or deaths due to pneumonia. The patients were hospitalized or died due to pneumonia between 2005 and 2012. Then, the researchers compared those patients to matched cohorts that did not have Alzheimer’s disease.

If patients had used antipsychotic prescriptions or had pneumonia within the past year of the study baseline, they were excluded. They were also excluded from the study if they had schizophrenia or bipolar disorder.

The researchers learned that the pneumonia incidence during a period of antipsychotic medication use was similar in the Alzheimer’s disease population and the non Alzheimer’s disease population; however, the higher risk of pneumonia for Alzheimer’s disease patients was found during periods of no medication use. The researchers extrapolated that antipsychotic medication use was, therefore, linked to a two-fold risk of pneumonia in Alzheimer’s disease patients, and about a three and a half fold increase among patients without Alzheimer’s disease.

The study authors continued in their statement that antipsychotic medication use presents a risk for pneumonia regardless of a patient’s age, applied study design, treatment duration, choice of medication, or comorbidities.

Because the study only included cases where the patient was hospitalized or died from pneumonia, the researchers estimated that the actual risk might be even higher than what they determined in this study. As such, the authors advise doctors to carefully consider the risk benefit balance when prescribing antipsychotics — they also recommended that the treatment period should be as brief as possible.

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