Safety Profile Assessment of Risperidone and Olanzapine in Long-Term Care Patients with Dementia

Abstract

Among long-term care residents with dementia who received low doses of risperidone or olanzapine, the incidence of adverse events was low. When considering adverse events of particular concern in the elderly, specifically falls and laxative use, risperidone may be preferred over olanzapine in this population.

Fall risk factors in older people with dementia or cognitive impairment: a systematic review

“…2004), the number of prospective studies particularly investigating falls as an adverse effect of drugs in people with dementia is limited. Recent pharmaceutical studies suggest that atypical antipsychotics might be superior to typical psychotics with regard to falls as an adverse effect (Martin et al. 2003, Katz et al.…”

Atypical Antipsychotic Medications and Risk of Falls in Residents of Aged Care Facilities

“…In a small (n=39) head‐to‐head randomized trial comparing olanzapine and risperidone in people with dementia, there were six falls in the olanzapine group (n=20) and four in the risperidone group (n=19) 20 . A larger observational epidemiological study (n=730) found a statistically significantly higher risk of falls in olanzapine users than risperidone users 21 . The study involved people with dementia living in U.S. nursing homes and compared fall rates in the first 3 months of use of these medications.…”

The Quality of Antipsychotic Drug Prescribing in Nursing Homes

“…The atypicals share a receptor-blocking profile widely promoted as causing less tardive dyskinesia and other movement disorders compared with the conventional agents; however, clinical trials of atypicals show serious adverse events including falls, somnolence, and abnormal gait. [11][12][13][14][15] In the face of limited evidence, the wider use of antipsychotics in NHs deserves attention to understand the extent of new indications and new patient populations and the ability of established guidelines to protect NH residents from inappropriate use.…”