New research published in Chest indicates that use of antipsychotic medications may be associated with a higher risk of pneumonia in patients with Alzheimer’s disease. 

To date, only a single small study has assessed the risk of pneumonia in regards to antipsychotic use in patients with Alzheimer’s disease. University of Eastern Finland researchers evaluated whether incident or specific antipsychotic use was related to an increased risk of hospitalization or death due to pneumonia in the MEDALZ cohort. The MEDALZ cohort included 60,584 with clinically verified Alzheimer’s diagnosis, of which 12,225 had incident pneumonia. This cohort was matched with a comparison cohort without Alzheimer’s disease (n=60,584) of which 6,195 had incident pneumonia. 

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Researchers found that antipsychotic use was associated with a higher pneumonia risk (adjusted hazard ratio [aHR] 2.01, 95% CI: 1.90–2.13) in the Alzheimer’s disease cohort and somewhat higher risk in the non-Alzheimer’s disease cohort (aHR 3.43, 95% CI: 2.99–3.93). In the case-crossover analyses, the study authors found similar results with an OR of 2.02 (95% CI: 1.75-–2.34) in the Alzheimer’s disease cohort and OR of 2.59 (95% CI: 1.77–3.79) in the non-Alzheimer’s disease cohort. 

Quetiapine, risperidone, and haloperidol all demonstrated similar associations with the risk of pneumonia.

In general, the use of antipsychotics was associated with a higher risk of pneumonia despite study design, treatment duration or drug choice. Study authors were not able to fully exclude a shared causality between pneumonia and antipsychotic use however the risk-benefit should be considered when prescribingantipsychotics

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