Bijwerkingen van antipsychotica: Een samenvatting van twee proefschriften

This article provides a overview of five Dutch studies that contribute to extention of knowledge about side effects of antipsychotics in the elderly. Four studies were conducted using the PHARMO database and examined possible cardiovascular and infectious (pneumonia) complications. A cross-sectional study examined factors that possibly influence the variation in occurrence of haloperidol induced parkinsonism. Use of antipsychotics in the elderly increases the risk of pneumonia and cerebrovascular adverse events, especially during the first week of treatment. No evidence was found of an increased risk of venous thromboembolism in elderly patients using antipsychotics. A decreased risk of hospitalisation for acute coronary syndrome in elderly patients using antipsychotics was found. During use of haloperidol a prevelance of parkinsonism of 46% was found in a very old population, with mean age of 83 years. A decrease in risk of haloperidol induced parkinsonism was found in carriers of the -759T allele of the HTR2C gene. No association was found between parkinsonism and the prescribed dose nor plasma concentration of haloperidol.