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Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011.

https://arctichealth.org/en/permalink/ahliterature297761
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2018
Author
G Selbæk
S I M Janus
S Bergh
K Engedal
S Ruths
A S Helvik
J Šaltyte Benth
S U Zuidema
Author Affiliation
Norwegian National Advisory Unit on Ageing and Health,Vestfold Hospital Trust,Tønsberg,Norway.
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Date
03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Antipsychotic Agents - therapeutic use
Behavioral Symptoms - drug therapy - psychology
Cognition Disorders - drug therapy - psychology
Cohort Studies
Dementia - drug therapy - psychology
Drug Utilization - statistics & numerical data
Female
Homes for the Aged
Humans
Length of Stay - statistics & numerical data
Male
Norway - epidemiology
Nursing Homes - statistics & numerical data
Psychotic Disorders - drug therapy - epidemiology
Psychotropic Drugs - administration & dosage - therapeutic use
Abstract
ABSTRACTBackground:We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed.
We conducted a secondary analysis of two cohort studies of two Norwegian nursing home samples (2004/05 and 2010/11). Multivariate models were applied.
We found a significant decrease in the prescription of antipsychotic drugs between 2004 and 2011 (0.63 OR, 95%CI = 0.49-0.82, p
PubMed ID
28988552 View in PubMed
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Childhood predictors of antipsychotic use among young people in Finland.

https://arctichealth.org/en/permalink/ahliterature125500
Source
Pharmacoepidemiol Drug Saf. 2012 Sep;21(9):964-71
Publication Type
Article
Date
Sep-2012
Author
David Gyllenberg
Andre Sourander
Hans Helenius
Lauri Sillanmäki
Jukka Huttunen
Jorma Piha
Kirsti Kumpulainen
Tuula Tamminen
Irma Moilanen
Fredrik Almqvist
Author Affiliation
Department of Child Psychiatry, University of Helsinki and Helsinki University Central Hospital, Finland. david.gyllenberg@helsinki.fi
Source
Pharmacoepidemiol Drug Saf. 2012 Sep;21(9):964-71
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Antipsychotic Agents - administration & dosage - therapeutic use
Child
Female
Finland - epidemiology
Follow-Up Studies
Hospitalization
Humans
Longitudinal Studies
Male
Mental Disorders - drug therapy - epidemiology - physiopathology
Mood Disorders - drug therapy - epidemiology
Psychotic Disorders - drug therapy - epidemiology
Registries
Sex Factors
Young Adult
Abstract
Information on who uses antipsychotic medication is limited to cross-sectional data. The objective of this study was to study the patterns of psychopathology at age 8?years and antipsychotic use between the ages of 12 and 25?years.
A total of 5525 subjects from the Finnish Nationwide 1981 birth cohort were linked to the National Prescription Register and the Hospital Discharge Register between 1994 and 2005. Information about parent-reported and teacher-reported conduct, hyperkinetic and emotional symptoms, and self-reported depressive symptoms was gathered at age 8?years. Information about antipsychotic use and about psychiatric disorders treated in hospitals between the ages of 12 and 25?years was register based. Diagnostic classes of hospital treatment included non-affective psychoses, affective disorders, and other psychiatric disorders.
The cumulative incidence of antipsychotic use by age 25?years was 2.8% among men (n?=?69) and 2.1% among women (n?=?55). In both sexes, living with other than two biological parents at age 8?years was associated with antipsychotic use, and three fourths of antipsychotic users had been treated for psychiatric disorders in a hospital. Among men, the most common hospital diagnosis was non-affective psychoses (44% of all antipsychotic users), and antipsychotic use was associated with childhood conduct problems. Among women, the most common hospital diagnosis was affective disorders (38% of all antipsychotic users), and antipsychotic use was associated with emotional problems and self-reported depressive symptoms in childhood.
Antipsychotic use in adolescence and young adulthood is different among men versus women both with regard to hospital diagnoses and childhood psychiatric problems.
PubMed ID
22473622 View in PubMed
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Clinical epidemiologic first-episode psychosis: 1-year outcome and predictors.

https://arctichealth.org/en/permalink/ahliterature163098
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Publication Type
Article
Date
Jul-2007
Author
E. Simonsen
S. Friis
U. Haahr
J O Johannessen
T K Larsen
I. Melle
S. Opjordsmoen
B R Rund
P. Vaglum
T. McGlashan
Author Affiliation
Roskilde Psychiatric University Hospital Fjorden, Roskilde, Denmark. rfes@ra.dk
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adult
Affect
Denmark - epidemiology
Female
Humans
Male
Norway - epidemiology
Prospective Studies
Psychotic Disorders - drug therapy - epidemiology
Remission Induction
Schizophrenia - drug therapy - epidemiology
Social Behavior
Abstract
To describe 1-year outcome in a large clinical epidemiologic sample of first-episode psychosis and its predictors.
A total of 301 patients with first-episode psychosis from four healthcare sectors in Norway and Denmark receiving common assessments and standardized treatment were evaluated at baseline, at 3 months, and at 1 year.
Substantial clinical and social improvements occurred within the first 3 months. At 1-year 66% were in remission, 11% in relapse, and 23% continuously psychotic. Female gender and better premorbid functioning were predictive of less severe negative symptoms. Shorter DUP was predictive for shorter time to remission, stable remission, less severe positive symptoms, and better social functioning. Female gender, better premorbid social functioning and more education also contributed to a better social functioning.
This first-episode sample, being well treated, may be typical of the early course of schizophrenia in contemporary centers.
PubMed ID
17559601 View in PubMed
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The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes--a 12-month follow-up study.

https://arctichealth.org/en/permalink/ahliterature92868
Source
Am J Geriatr Psychiatry. 2008 Jul;16(7):528-36
Publication Type
Article
Date
Jul-2008
Author
Selbaek Geir
Kirkevold Øyvind
Engedal Knut
Author Affiliation
Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway. geir.selbaek@aldringoghelse.no
Source
Am J Geriatr Psychiatry. 2008 Jul;16(7):528-36
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Behavioral Symptoms - drug therapy - epidemiology
Dementia - drug therapy - epidemiology - psychology
Depressive Disorder - drug therapy - epidemiology
Drug Utilization
Female
Humans
Male
Norway - epidemiology
Nursing Homes
Prevalence
Prospective Studies
Psychomotor Agitation - drug therapy - epidemiology
Psychotic Disorders - drug therapy - epidemiology
Psychotropic Drugs - administration & dosage - adverse effects - therapeutic use
Abstract
OBJECTIVE: This study investigates the natural course of neuropsychiatric symptoms and the concomitant use of psychotropic medication among a large and representative sample of nursing-home patients with dementia. METHOD: The authors performed two data collections with structured interviews in a 1-year follow-up cohort-study including 26 nursing homes in four counties in two Norwegian health regions. The main outcome measures were baseline and follow-up frequencies, persistence and incidence of neuropsychiatric symptoms, and the change in neuropsychiatric symptoms with regard to the use of psychotropic medication. RESULTS: At baseline a representative sample of 1,163 nursing-home patients participated, of whom 933 had dementia. At the follow-up interview after 1 year, 633 of the patients who had dementia at baseline were assessed. Clinically significant neuropsychiatric symptoms were exhibited by 84% of patients with dementia at the baseline or follow-up interviews. Overall persistence of symptoms was 79%. Individual symptoms, such as depression (58%), delusions (56%), and agitation/aggression (47%) had resolved at a high rate. Persistent use of antidepressants (79%), antipsychotics (75%), or any psychotropic drug (88%) was common. There were no differences between users and nonusers of antipsychotics or antidepressants regarding the course of psychosis, agitation, or depression over the 1-year observation period. CONCLUSION: Neuropsychiatric symptoms are ubiquitous in nursing home patients with dementia. Overall the symptoms are chronically present, whereas individual symptoms often show an intermittent course. Long-term use of psychotropic medication is extensive. Uncertainty about treatment effects emphasizes the need for further treatment trials.
PubMed ID
18591573 View in PubMed
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Early non-adherence to medication and other risk factors for rehospitalization in schizophrenia and schizoaffective disorder.

https://arctichealth.org/en/permalink/ahliterature130652
Source
Schizophr Res. 2011 Dec;133(1-3):36-41
Publication Type
Article
Date
Dec-2011
Author
Robert Bodén
Lena Brandt
Helle Kieler
Morten Andersen
Johan Reutfors
Author Affiliation
Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden. robert.boden@neuro.uu.se
Source
Schizophr Res. 2011 Dec;133(1-3):36-41
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - adverse effects
Female
Hospitalization - statistics & numerical data
Humans
Length of Stay - statistics & numerical data
Male
Medication Adherence - psychology
Proportional Hazards Models
Psychiatric Status Rating Scales
Psychotic Disorders - drug therapy - epidemiology
Risk factors
Schizophrenia - drug therapy - epidemiology
Sweden
Young Adult
Abstract
Non-adherence to antipsychotic medication and hospitalization in psychotic disorders are common and costly problems. Our aim was to identify risk factors for rehospitalization of patients with recent onset schizophrenia or schizoaffective disorder in a population-based cohort study. All patients with a first hospitalization for schizophrenia or schizoaffective disorder between 2006 and 2007 were included (n = 861). Patients were identified through and data retrieved from national Swedish health and population registers. We investigated how socio-demographic variables, duration of first hospitalization and prescription fills of antipsychotics were associated with rehospitalization in Cox regression models. A higher risk for rehospitalization within 28 days was observed in patients with a first hospitalization that was shorter than two weeks compared with patients who were hospitalized for more than four weeks: hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.42 to 3.74. Further, patients who did not fill a prescription of antipsychotics within the first week after discharge had a higher risk of early rehospitalization than patients who were given antipsychotics (HR 1.75, 95% CI 1.13 to 2.72). More than 12 years of education was associated with a lower risk of early rehospitalization (HR 0.44, 95% CI 0.26 to 0.77). Sex, age, being born in Sweden, urban area residence and prescription fills of antipsychotics prior to first admission did not significantly affect the risk of early rehospitalization. In conclusion, we identified two potentially modifiable risk factors for rehospitalization: short duration of initial hospitalization and early non-adherence to medication.
PubMed ID
21982098 View in PubMed
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A genome wide linkage study of obesity as secondary effect of antipsychotics in multigenerational families of eastern Quebec affected by psychoses.

https://arctichealth.org/en/permalink/ahliterature179438
Source
Mol Psychiatry. 2004 Dec;9(12):1067-74
Publication Type
Article
Date
Dec-2004
Author
Y C Chagnon
C. Mérette
R H Bouchard
C. Emond
M-A Roy
M. Maziade
Author Affiliation
Laval University Research Center Robert-Giffard, Beauport, Québec G1J 2B3, Canada. yvon.chagnon@crulrg.ulaval.ca
Source
Mol Psychiatry. 2004 Dec;9(12):1067-74
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Antipsychotic Agents - adverse effects
Bipolar Disorder - drug therapy - epidemiology - genetics
Chlorpromazine - adverse effects
Chromosomes, Human, Pair 12 - genetics
Comorbidity
Genetic Linkage
Genetic Predisposition to Disease
Haloperidol - adverse effects
Humans
Hypothalamic Hormones - genetics
Lod Score
Models, Genetic
Obesity - chemically induced - epidemiology - genetics
Pedigree
Protein Precursors - genetics
Psychotic Disorders - drug therapy - epidemiology - genetics
Quebec - epidemiology
Schizophrenia - drug therapy - epidemiology - genetics
Abstract
Antipsychotics can induce in schizophrenic (SZ) and bipolar disorder (BP) patients serious body weight changes that increase risk for noncompliance to medication, and risk for cardiovascular diseases and diabetes. A genetic origin for this susceptibility to weight changes has been hypothesized because only a proportion of treated patients are affected, the degree of affection differing also in rates and magnitudes. In a first genome scan on obesity under antipsychotics in SZ and BP, we analyzed 21 multigenerational kindreds (508 family members) including several patients treated for a minimum of 3 years mainly with haloperidol or chlopromazine. Obesity was defined from medical files and was shown to be 2.5 times more frequent in patients treated with antipsychotics than in untreated family members (30 vs 12%). The nine pedigrees that showed at least two occurrences of obesity under antipsychotics were submitted to model-based linkage analyses. We observed a suggestive linkage with a multipoint Lod score (MLS) of 2.74 at 12q24. This linkage finding vanished when we used as phenotypes, obesity unrelated to antipsychotics, and when we used SZ or BP. This suggests that this positive linkage result with obesity is specific to the use of antipsychotics. A potential candidate gene for this linkage is the pro-melanin-concentrating hormone (PMCH) gene located at less then 1 cM of the linkage. PMCH encodes a neuropeptide involved in the control of food intake, energy expenditure, and in anxiety/depression. This first genome scan targeting the obesity side effect of antipsychotics identified 12q24 as a susceptibility region.
PubMed ID
15224101 View in PubMed
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Health care use, drug treatment and comorbidity in patients with schizophrenia or non-affective psychosis in Sweden: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature292467
Source
BMC Psychiatry. 2017 12 29; 17(1):416
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-29-2017
Author
Erica M Brostedt
Mussie Msghina
Marie Persson
Björn Wettermark
Author Affiliation
Department of Healthcare Development, Public Health Care Services, Stockholm County Council, Box 6909, 102 39, Stockholm, Sweden. Erica.Brostedt@sll.se.
Source
BMC Psychiatry. 2017 12 29; 17(1):416
Date
12-29-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Comorbidity
Cross-Sectional Studies
Diabetes Mellitus - epidemiology - psychology
Female
Humans
Hypertension - epidemiology - psychology
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Prevalence
Psychotic Disorders - drug therapy - epidemiology - psychology
Schizophrenia - drug therapy - epidemiology
Substance-Related Disorders - epidemiology - psychology
Sweden - epidemiology
Young Adult
Abstract
This study investigated the prevalence of schizophrenia (ICD-10 F 20) and of other non-affective psychosis (NAP, ICD-10 F 21 - F 29) in Sweden. It further assessed health care use, comorbidity and medication for these patient groups. Most studies either have a study population of patients with strictly defined schizophrenia or a psychosis population of which strict schizophrenia cases form a smaller set. The present study permits comparison of the two mutually exclusive patient groups using data at the individual level in the diagnosis of non-affective psychosis, use of health care, medical treatment and comorbidity by diagnosis or medical treatment.
In 2012, data were extracted from a regional registry containing patient-level data on consultations, hospitalisations, diagnoses and dispensed drugs for the total population in the region of Stockholm (2.1 million inhabitants). The size of the total psychosis population was 18,769, of which 7284 had a diagnosis of schizophrenia. Crude prevalence rates and risk rates with 95% confidence intervals were calculated.
In 2012, the prevalence of schizophrenia and NAP was 3.5/1000 and 5.5/1000, respectively. Schizophrenia was most common among patients aged 50-59 years and NAP most common among patients aged 40-49 years. Schizophrenia patients used psychiatric health care more often than the NAP patients but less overall inpatient care (78.6 vs. 60.0%). The most prevalent comorbidities were substance abuse/dependence (7.9% in the schizophrenia group vs. 11.7% in the NAP group), hypertension (7.9 vs. 9.7%) and diabetes (6.9 vs. 4.8%). The parenteral form of long-acting injectable antipsychotics was more often dispensed to patients with schizophrenia (10 vs. 2%).
This study, analysing all diagnoses recorded in a large health region, confirmed prevalence rates found in previous studies. Schizophrenia patients use more psychiatric and less overall inpatient health care than NAP patients. Differences between the two patient groups in comorbidity and drug treatment were found. The registered rates of a substance abuse/dependence diagnosis were the most common comorbidity observed among the patients investigated. The observed differences between the schizophrenia and the NAP patients in health care consumption, comorbidity and drug treatment are relevant and warrant further studies.
Notes
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PubMed ID
29284436 View in PubMed
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The incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorders in children and adolescents.

https://arctichealth.org/en/permalink/ahliterature297420
Source
Eur Psychiatry. 2018 03; 49:16-22
Publication Type
Journal Article
Date
03-2018
Author
Ragnar Nesvåg
Jørgen G Bramness
Marte Handal
Ingeborg Hartz
Vidar Hjellvik
Svetlana Skurtveit
Author Affiliation
Nydalen DPS, Department of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway. Electronic address: ragnar.nesvag@legeforeningen.no.
Source
Eur Psychiatry. 2018 03; 49:16-22
Date
03-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Antipsychotic Agents - therapeutic use
Aripiprazole - therapeutic use
Child
Child, Preschool
Comorbidity
Depressive Disorder, Major - drug therapy - epidemiology
Female
Humans
Incidence
Infant
Male
Mental Disorders - drug therapy - epidemiology
Norway - epidemiology
Olanzapine - therapeutic use
Prevalence
Psychotic Disorders - drug therapy - epidemiology
Quetiapine Fumarate - therapeutic use
Risperidone - therapeutic use
Schizophrenia - drug therapy - epidemiology
Abstract
Antipsychotic drug use among children and adolescents is increasing, and there is growing concern about off-label use and adverse effects. The present study aims to investigate the incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorder in Norwegian children and adolescents.
We obtained data on mental disorders from the Norwegian Patient Registry on 0-18?year olds who during 2009-2011 were diagnosed for the first time with schizophrenia-like disorder (International Classification of Diseases, 10th revision codes F20-F29), bipolar disorder (F30-F31), or severe depressive episode with psychotic symptoms (F32.3 or F33.3). Data on filled prescriptions for psychotropic drugs were obtained from the Norwegian Prescription Database.
A total of 884 children and adolescents (25.1 per 100 000 person years) were first time diagnosed with schizophrenia-like disorder (12.6 per 100 000 person years), bipolar disorder (9.2 per 100 000 person years), or severe depressive episode with psychotic symptoms (3.3 per 100 000 person years) during 2009-2011. The most common co-morbid mental disorders were depressive (38.1%) and anxiety disorders (31.2%). Antipsychotic drugs were prescribed to 62.4% of the patients, 72.0% of the schizophrenia-like disorder patients, 51.7% of the bipolar disorder patients, and 55.4% of the patients with psychotic depression. The most commonly prescribed drugs were quetiapine (29.5%), aripiprazole (19.6%), olanzapine (17.3%), and risperidone (16.6%).
When a severe mental disorder was diagnosed in children and adolescents, the patient was usually also prescribed antipsychotic medication. Clinicians must be aware of the high prevalence of depressive and anxiety disorders among early psychosis patients.
PubMed ID
29366845 View in PubMed
Less detail
Source
J Clin Psychiatry. 1999;60 Suppl 2:85-8; discussion 111-6
Publication Type
Article
Date
1999
Author
A. Nilsson
Author Affiliation
Karsudden Hospital, Katrineholm, Sweden. agneta.nilsson@ka.dll.se
Source
J Clin Psychiatry. 1999;60 Suppl 2:85-8; discussion 111-6
Date
1999
Language
English
Publication Type
Article
Keywords
Cause of Death
Female
Follow-Up Studies
Hospitalization
Humans
Lithium - adverse effects - therapeutic use
Male
Mass Screening - methods
Middle Aged
Mood Disorders - drug therapy - epidemiology - psychology
Psychotic Disorders - drug therapy - epidemiology - psychology
Risk factors
Substance Withdrawal Syndrome - epidemiology - etiology - psychology
Suicide - psychology - statistics & numerical data
Sweden - epidemiology
Abstract
BACKGROUND: Studies from the early 90s have suggested that patients selected for and compliant with treatment at specialized lithium clinics have lower-than-expected suicide rates. The present study examines whether such findings can be replicated under less select treatment conditions. METHOD: All 362 patients in Göteborg, Sweden, with DSM-III-R mood or schizoaffective disorders, hospitalized at least once during an 8-year period and treated with lithium for a minimum of 1 year, were followed. The study included 3911 patient-years on lithium and, because of permanent or temporary discontinuation, 1274 patient-years off lithium. RESULTS: The risk of suicide was significantly increased on (standard mortality ratio [SMR] = 6.1) as well as off lithium (SMR = 29.0), but the relative risk of suicide was 4.8 times higher during periods off lithium (p
PubMed ID
10073393 View in PubMed
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Maternal use of antipsychotics in early pregnancy and delivery outcome.

https://arctichealth.org/en/permalink/ahliterature93176
Source
J Clin Psychopharmacol. 2008 Jun;28(3):279-88
Publication Type
Article
Date
Jun-2008
Author
Reis Margareta
Källén Bengt
Author Affiliation
Division of Clinical Pharmacology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Source
J Clin Psychopharmacol. 2008 Jun;28(3):279-88
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Abnormalities, Drug-Induced - epidemiology - etiology
Adult
Anticonvulsants - adverse effects - therapeutic use
Antiemetics - adverse effects - therapeutic use
Antipsychotic Agents - adverse effects - therapeutic use
Cesarean Section - statistics & numerical data
Diabetes, Gestational - chemically induced - epidemiology
Female
Heart Defects, Congenital - chemically induced - epidemiology
Humans
Infant, Newborn
Lithium Compounds - adverse effects - therapeutic use
Odds Ratio
Phenothiazines - adverse effects - therapeutic use
Pregnancy
Pregnancy Complications - drug therapy - epidemiology
Pregnancy outcome
Pregnancy, Multiple
Prochlorperazine - adverse effects - therapeutic use
Psychotic Disorders - drug therapy - epidemiology
Registries
Risk
Sweden
Abstract
The effect of various antipsychotics during pregnancy has repeatedly been studied, but for most atypical antipsychotics, only little information is available. We identified from the Swedish Medical Birth Register 2908 women who had reported the use of any antipsychotic or lithium in early pregnancy and studied malformation rates with data also from the Register of Congenital Malformations and the Hospital Discharge Register. Comparisons were made with all births (n = 958,729) after adjustment for some confounders. Risks were expressed as odds ratios (ORs).Most women had used dixyrazine or prochlorperazine mainly because of nausea and vomiting in early pregnancy. Seventy-nine women had used lithium, and these outcomes are reported separately. Hence, the main analysis was restricted to 570 women (576 infants) using other antipsychotics. There was a statistically significant increase in the risk for a congenital malformation-after exclusion of some common and minor conditions, the OR was 1.52 (95% confidence interval, 1.05-2.19). Exclusion of infants exposed to anticonvulsants reduced the OR only slightly. Most of the increased risk was caused by cardiovascular defects, mainly atrium or ventricular septum defect. No certain drug specificity was found. Except for an increased risk for congenital malformations, a nearly doubling of the risk for gestational diabetes and a 40% increased risk for cesarean delivery was noted. Because there seems to be little drug specificity, it is possible that underlying pathology or unidentified confounding explains the excess risk.
Notes
Comment In: Evid Based Ment Health. 2009 Feb;12(1):2919176788
PubMed ID
18480684 View in PubMed
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17 records – page 1 of 2.