Atypical antipsychotic drug use is associated with an increased risk for acute kidney injury (AKI) and other adverse outcomes, according to a study being published in Annals of Internal Medicine.

Each year, millions of older adults are prescribed atypical antipsychotic drugs (quetiapine, risperidone, and olanzapine) to manage behavioral symptoms of dementia, which is not an approved indication. This type of off-label use has raised safety concerns, as these atypical antipsychotics are known to cause AKI. Researchers compared medical records for 97,777 adults aged 65 or older who received a new outpatient prescription for an oral atypical antipsychotic drug against a matched cohort of patients who had not received such a prescription to determine the risk for AKI and other adverse outcomes.

Persons who had received a prescription for any three atypical antipsychotic drugs in the previous 90 days had an elevated risk for hospitalization with AKI. The drugs were also associated with increased risk for hypotension, acute urinary retention, and death. The findings support current safety concerns regarding the use of these drugs in older adults.

Study: Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults: A Population-Based Cohort Study, Y.J. Hwang, S.N. Dixon, J.P. Reiss, R. Wald, C.R. Parikh, S. Gandhi, S.Z. Shariff, N. Pannu, D.M. Nash, F. Rehman, and A.X. Garg, Annals of Internal Medicine, doi: 10.7326/M13-2796, published 18 August 2014.