Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Antipsychotics Linked with Unexpected Child Deaths

JAMA Psychiatry; ePub 2018 Dec 12; Ray, Stein, et al

Recent findings suggest that antipsychotic use is associated with increased risk of unexpected death in children and youths and appear to reinforce recommendations for careful prescribing and monitoring of antipsychotic treatment. Researchers conducted a retrospective cohort study from 1999 through 2014 and included Medicaid enrollees aged 5 to 24 years who had no diagnosis of severe somatic illness, schizophrenia or related psychoses, or Tourette syndrome or chronic tic disorder. Included were 189,361 children and youths in the control group (mean [SD] age, 12.0 [5.1] years; 43.4% female), 28,377 in the lower-dose group (mean [SD] age, 11.7 [4.4] years; 32.3% female), and 30,120 in the higher-dose group (mean [SD] age, 14.5 [4.8] years; 39.2% female). They found:

  • The unadjusted incidence of death in the higher-dose group was 146.2 per 100,000 person-years (40 deaths per 27,354 person-years), which was significantly greater than that in the control group (54.5 per 100,000 population; 67 deaths per 123,005 person-years).
  • The difference was primarily attributable to the increased incidence of unexpected deaths in the higher-dose group (21 deaths; 76.8 per 100,000 population) compared with the control group (22 deaths; 17.9 per 100,000 population).
Citation:

Ray WA, Stein M, Murray KT, et al. Association of antipsychotic treatment with risk of unexpected death among children and youths. [Published online ahead of print December 12, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.3421.

This Week's Must Reads

Early-Life Stress Linked with Cytomegalovirus in MDD , JAMA Psychiatry; ePub 2019 Mar 6; Ford, et al

Collaborative Intervention for Obesity, Depression , JAMA; 2019 Mar 5; Ma, Goldman Rosas, Lv, et al

Body Weight Predicts Risk for Depressive Symptoms , J Affect Disord; ePub 2019 Mar 5; Vittengl

Slow-Wave Activity and Mood Disturbance in MDD, Psychol Med; 2019 Mar; Goldschmied, et al

Marijuana Use in MDD May Be Contraindicated, Cogn Affect Behav Neurosci; ePub 2019 Feb 26; Radoman, et al

Must Reads in Pediatrics

Antipsychotics Linked with Unexpected Child Deaths, JAMA Psychiatry; ePub 2018 Dec 12; Ray, Stein, et al

Pediatric Anxiety Diagnoses and Hospitalizations, Depress Anxiety; ePub 2018 Oct 24; Bushnell, et al

Weight Control Behaviors Persist into Adulthood, Int J Eat Disord; ePub 2018 Oct 24; Haynos, et al

Early Life Stress and Early Adolescent Substance Use, Addiction; ePub 2018 Oct 3; Otten, Mun, et al