Psychiatry - July 2008 - (Page 28)

Trend Watch Lundbeck, Medivation, Merck, Myriad, Novartis, Pfizer, Prana, Sonexa, Takeda, Wyeth pharmaceutical companies. Dr. Cummings owns stock in ADAMAS, Prana, Sonexa. Dr. Cummings owns the copyright of the Neuropsychiatric Inventory. ABSTRACT: Recent research on dementia patients suggests that use of antipsychotics may increase risk of hospitalization or death. While bipolar disorder and schizophrenia combine to represent more than 70 percent of atypical antipsychotic uses in younger patients, these same indications represent only 38 percent of product use in patients age 65 and older. The difference between the two age groups is driven primarily by use in cognitive impairment: Dementia and Alzheimer’s combine to account for 28 percent of atypical antipsychotic use in older patients. Although ICD-9 coding tends to group patients into less specific diagnoses, we did isolate a small group of approximately 10 percent of patients that were classified based on the presence or absence of behavior disturbances. Eighteen percent of dementia patients without behavioral disturbances received atypical antipsychotics as compared to 66 percent of patients with behavioral disturbances. A discussion of the results is provided. Use of Atypical Antipsychotics in the Elderly by Elisa Cascade; Amir H. Kalali, MD; and Jeffrey L. Cummings, MD AUTHOR AFFILIATIONS: Ms. Cascade is Vice President, Quintiles Inc./iGuard, Falls Church, Virginia; Dr. Kalali is Vice President, Global Therapeutic Group Leader CNS, Quintiles Inc., San Diego, California, and Professor of Psychiatry, University of California, San Diego; and Dr. Cummings is from the Departments of Neurology and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California. ADDRESS CORRESPONDENCE TO: Ms. Elisa Cascade, Vice President, Quintiles, Inc./iGuard, 3130 Fairview Park Drive, Suite 501, Falls Church, VA 22042; E-mail: elisa.cascade@quintiles.com FINANCIAL DISCLOSURES: Dr. Cummings has provided consultation to Abbott, Acadia, Accera, ADAMAS, Astellas, Avanir, CoMentis, Eisai, Elan, EnVivo, Forest, Janssen, Lilly, KEY WORDS: Alzheimer’s, dementia, antipsychotics INTRODUCTION Recent research on dementia patients suggests that use of antipsychotics may increase risk of hospitalization or death. In this article, we examine prevalence of atypical antipsychotic use in patients over the age of 65 and reasons for product use. METHODS We obtained data from two different sources: 1) patients taking atypical antipsychotics from Verispan’s Total Patient Tracker, May, 2007, to April, 2008, and 2) 28 28 Psychiatry 2008 [ J U L Y ]

Table of Contents Feed for the Digital Edition of Psychiatry - July 2008

Psychiatry - July 2008 Editor's Message Editorial Advisory Board Contents PsychRx Letters to the Editor Reliability of Diagnoses: Do Psychiatrists Use Structured Interviews In Real Clinical Settings? Trend Watch: Use of Atypical Antipsychotics in the Elderly Review: The Struggle for Mental Healthcare in New Orleans-One Case at a Time Psychotherapy Rounds: Psychotherapeutic and Adjuntive Pharmacologic Approaches to Treating Posttraumatic Stress Disorder Original Research: Baseline Dissociation and Prospective Success in Special Forces Assessment and Selection Commentary: Performance-Enhancing Drugs: Where Should the Line Be Drawn and By Whom? Commentary: Psychiatric Diagnosis and the Pathlogist's View of Schizophrenia Journal Watch Classified Advertising Information for Authors

Psychiatry - July 2008

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