Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Clozapine and mortality: A comparison with other antipsychotics in a nationwide Danish cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Number of Traumatic brain injuries and temporal associations with depression: A register-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Structural brain abnormalities associated with cognitive impairments in bipolar disorder

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Severe mental illness is associated with increased mortality and severe course of COVID-19

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Reducing the rate of psychiatric Re-ADMISsions in Bipolar Disorder using smartphones The RADMIS trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Hippocampal Volume and Memory Impairment after Electroconvulsive Therapy in Patients with Depression

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Antipsychotic medication exposure, clozapine, and pneumonia: results from a self-controlled study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The use of stimulants in depression: Results from a self-controlled register study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Clozapine and COVID-19: The authors respond

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  • Yvonne van der Zalm
  • Leslie Foldager
  • Fabian Termorshuizen
  • Iris E Sommer
  • Jimmi Nielsen
  • Jean-Paul Selten
Vis graf over relationer

OBJECTIVE: To compare the mortality in people using clozapine to that of people using other antipsychotics.

METHODS: Danish incidence cohort of 22,110 patients with a first diagnosis of non-affective psychotic disorder (1995-2013) and a prevalence cohort of 50,881 patients ever diagnosed with such a disorder (1969-2013). Hazard ratios (HR) were calculated for the antipsychotic drug used at the time of death ("current use": incidence and prevalence cohort) and for the drug used for the longest at that moment ("cumulative use": incidence cohort), using a Cox model with adjustment for somatic comorbidity. Clozapine was the reference drug.

RESULTS: As for current drug use, the risk of suicide was higher among users of other antipsychotics in the incidence (HRadj = 1.76; 95% CI 0.72-4.32) and prevalence (HRadj = 2.20; 95% CI 1.35-3.59) cohorts. There was no significant difference in all-cause or cardiovascular mortality in the two cohorts. Cumulative use of clozapine was not associated with an increased cardiovascular mortality. Cumulative use of other antipsychotics for up to 1 year was associated with a lower all-cause mortality and suicide risk than a similar period of clozapine use (all-cause: HRadj = 0.73; 95% CI 0.63-0.85, suicide; HRadj = 0.65; 95% CI 0.46-0.91).

CONCLUSION: The results indicate that the use of clozapine is not associated with increased cardiovascular mortality. We found opposing trends toward a lower risk of suicide during current use of clozapine and a higher risk of suicide associated with cumulative use up to 1 year. This suggests that clozapine cessation marks a period of high risk of suicide.

OriginalsprogEngelsk
TidsskriftActa Psychiatrica Scandinavica
Vol/bind143
Udgave nummer3
Sider (fra-til)216-226
Antal sider11
ISSN0001-690X
DOI
StatusUdgivet - mar. 2021

Bibliografisk note

© 2020 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.

ID: 61924869