HealthDay News — For older adults with dementia, trazodone is associated with a comparable risk for falls and fractures as that of atypical antipsychotics, according to a study published online November 26 in CMAJ, the Journal of the Canadian Medical Association.

Jennifer A. Watt, MD, from the University of Toronto, and colleagues compared the risk for falls and fractures among older adults with dementia who received trazodone or atypical antipsychotics. The cohort included adults with dementia living in long-term care who were aged 66 years and older; 6588 were new users of trazodone and 2875 were new users of an atypical antipsychotic. 

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The researchers found that use of trazodone correlated with similar rates of falls or major osteoporotic fractures compared with use of atypical antipsychotics (weighted hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.73 to 1.07); the rates of falls (weighted HR, 0.91; 95% CI, 0.75 to 1.11) and hip fractures (weighted HR, 0.92; 95% CI, 0.59 to 1.43) were also similar. The rate of mortality was lower in association with trazodone use (weighted HR, 0.75; 95% CI, 0.66 to 0.85).

“Watt and colleagues also underscore the importance of prioritizing nonpharmacological approaches for the management of behavioral and psychological symptoms of dementia,” write the authors of an accompanying editorial. “Nonpharmacological approaches comprise a variety of behavioral, environmental and caregiver-supportive interventions, and existing evidence suggests that these show greater effect than many psychotropic drug therapies.”

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