IntroductionCurrently, there are no Food and Drug Administration-approved therapies to treat dementia-related psychosis (DRP). This study investigated the association between using antipsychotics and the anticonvulsant divalproex (sodium valproate) to manage DRP and adverse outcomes.MethodsA retrospective case/control matching study evaluated the risk of mortality, extrapyramidal symptoms (EPS), ischemic stroke, and cardiac arrest/ventricular arrhythmia (CA/VA) with ever-use of antipsychotics/divalproex in patients with DRP vs never-use.Results49 509 patients were included; 76.8% used an antipsychotic/divalproex. Treatment ever-use was associated with an increased risk of all-cause mortality (odds ratio, 1.14; 95% CI, 1.10-1.18) and a smaller increase in the risk of EPS (1.10; 1.00-1.19) relative to never-use (adjusted for matching demographic variables, comorbid conditions, and disability).ConclusionsCurrent agents used for DRP were associated with increased risk of death and adverse outcomes. An increased risk of death was evident within 3 months of antipsychotic/divalproex initiation and persisted with long-term use.

中文翻译：

---

与用于治疗患有精神病的痴呆症患者的标签外药物相关的不良后果：一项病例对照医疗保险数据库研究


简介目前，尚无美国食品和药物管理局批准的治疗痴呆相关精神病 (DRP) 的疗法。本研究调查了使用抗精神病药和抗惊厥药双丙戊酸钠（丙戊酸钠）来控制 DRP 和不良后果之间的关联。方法一项回顾性病例/对照匹配研究评估了死亡、锥体外系症状 (EPS)、缺血性中风和心脏骤停/心室骤停的风险曾经使用过抗精神病药/双丙戊酸钠的 DRP 患者与从未使用过的心律失常 (CA/VA) 比较。 结果 49 509 名患者纳入其中； 76.8% 使用抗精神病药/双丙戊酸。与从未使用治疗相比，经常使用治疗与全因死亡率风险增加相关（比值比，1.14；95% CI，1.10-1.18），且 EPS 风险增加较小（1.10；1.00-1.19） （根据匹配的人口统计变量、合并症和残疾进行调整） 。结论当前用于 DRP 的药物与死亡风险和不良后果增加相关。开始使用抗精神病药物/双丙戊酸后 3 个月内，死亡风险明显增加，并且长期使用持续存在。