Antipsychotics

Antipsychotics Increase Risk for Acute Respiratory Failure

According to a recent study, antipsychotic use in patients with Chronic Obstructive Pulmonary Disease (COPD) was associated with an increased risk for acute respiratory failure.

Researchers located 5032 patients with COPD who were recently diagnosed with acute respiratory failure (ARF) in an emergency care or a hospital setting, and put on intubation or mechanical ventilation from January 1, 2000 to December 31, 2011 using the Taiwan National Health Insurance Research Database.
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The study compared the antipsychotic class, route of administration, and dosage within days 1 to 14 after acute respiratory failure, to days 75 to 88 prior to ARF.

According to their data, 590 patients (11.7%) with ARF filled at least 1 antipsychotic prescription compared to 443 (8.8%) prior to ARF. There was a 1.66-fold increased risk of ARF in patients taking antipsychotic medication, regardless of the class or administration route of the drug. Researchers also found a 1.52 increased risk for ARF in patients taking a low daily dose, and a 3.74-fold risk for patients taking a high daily dose of antipsychotics.

Their findings indicate that antipsychotic use and dosage were associated with an increased risk for ARF in patients with COPD.

“Clinicians should exercise caution when prescribing antipsychotics to patients with COPD and avoid high doses if possible,” the researchers concluded.

—Melissa Weiss

Reference:

Wang MT, Tsai CL, Lin CW, et al. Associations between antipsychotic agents and risk of acute respiratory failure in patients with chronic obstructive pulmonary disease [published online January 4, 2017]. Jama Psychiatry. doi:10.1001/jamapsychiatry.2016.3793.