Antipsychotic Initiation Ups Risk for Head Injury, TBI in Alzheimer Disease

Individuals with Alzheimer disease (AD) initiating antipsychotics have an increased risk for head injuries and traumatic brain injury (TBI), according to a study published online January in the Journal of the American Geriatrics Society.

Vesa Tapiainen, M.D., from the School of Pharmacy at the University of Eastern Finland in Kuopio, and colleagues conducted a nationwide register-based cohort study to examine the association between antipsychotic use and risk for head injuries among community dwellers with AD. Data were included for 21,795 pairs of incident antipsychotic users matched with nonusers by age, sex, and time since AD diagnosis.

The researchers observed an association between antipsychotic use and increased risk for head injuries (event rate per 100 person-years, 1.65 for users and 1.26 for nonusers; inverse probability of treatment [IPT]-weighted hazard ratio, 1.29) and TBI (event rate per 100 person-years, 0.90 and 0.72 for users and nonusers, respectively; IPT-weighted hazard ratio, 1.22). Compared with risperidone users, quetiapine users had higher TBI risk (IPT-weighted hazard ratio, 1.60).

"Persons with AD have a higher risk of falling, head injuries, and TBIs and worse prognosis after these events in comparison to those without AD," the authors write. "Therefore, it is important to avoid further increasing risk in this vulnerable population."

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