Study Links Atypical Antipsychotic Drugs to Acute Kidney Injury

A study published in Annals of Internal Medicine links the use of atypical antipsychotic medications to acute kidney injury (AKI) and other adverse effects. According to Renal & Urology News, these findings help explain the observation that antipsychotic drugs are associated with an increased risk of AKI.

The researchers stated that antipsychotic medications, “specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI).” This manifests as hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis.

The study was led by Amit X. Garg, MD, PhD, of professor of medicine and epidemiology at Western University in London, Ontario, and a researcher at the Institute for Clinical and Evaluative Sciences (ICES). They analyzed data from nearly 100,000 patients who received a new outpatient prescription for an oral antipsychotic drug and compared them to a matched group who did not have a prescription for these medications.

Among patients who used atypical antipsychotic drugs, the risk of being hospitalized for 90-days for AKI was nearly doubled compared to those without a prescription. Among patients who used the drugs, 5.5 percent were hospitalized for AKI. As a comparison, 3.3 percent of non-users were hospitalized with AKI. Antipsychotic drug use was also linked to hypotension, acute urinary retention and all-cause mortality. Association with these adverse effects may explain the link with AKI, Renal & Urology News reports.

The drugs already contain an FDA “black box” warning that they carry an increased risk of death in elderly patients. The authors wrote that “Atypical antipsychotic drug use is associated with an increased risk for AKI and other adverse outcomes that may explain the observed association with AKI. The findings support current safety concerns about the use of these drugs in older adults.”

Dr. Garg said the research “calls for a careful reevaluation of prescribing atypical antipsychotic drugs in older adults, especially for the unapproved indication of managing behavioral symptoms of dementia.” Renal & Urology News reports.

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