Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study

Abstract Aim No consensus has been reached on the association between the risk of falls and antipsychotic and antidepressant drug use. In this study, we evaluated the risk of falls with trazodone, risperidone, and quetiapine, which are recommended for use at Kanazawa Medical University Hospital. Met...

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Main Authors: Yoshihito Shimizu, Masatoshi Taga, Yoshimitsu Takahashi, Yasuhiko Yamamoto, Togen Masauji
Format: Article
Language:English
Published: Wiley 2022-12-01
Series:Neuropsychopharmacology Reports
Subjects:
Online Access:https://doi.org/10.1002/npr2.12297
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author Yoshihito Shimizu
Masatoshi Taga
Yoshimitsu Takahashi
Yasuhiko Yamamoto
Togen Masauji
author_facet Yoshihito Shimizu
Masatoshi Taga
Yoshimitsu Takahashi
Yasuhiko Yamamoto
Togen Masauji
author_sort Yoshihito Shimizu
collection DOAJ
description Abstract Aim No consensus has been reached on the association between the risk of falls and antipsychotic and antidepressant drug use. In this study, we evaluated the risk of falls with trazodone, risperidone, and quetiapine, which are recommended for use at Kanazawa Medical University Hospital. Methods We reviewed all patients who were admitted to Kanazawa Medical University Hospital between January 1st and December 31st, 2018. We excluded those aged <20 years and those admitted to pediatric, intensive care, and psychiatric wards. Finally, 9273 patients were included. We reviewed the incidence in these patients of accidental falls reported to the medical safety department. We noted whether these patients received trazodone, quetiapine, or risperidone. We also observed whether they were taking a benzodiazepine receptor agonist, which is a known risk factor. We further examined each patient's age, sex, the department they were visiting, and their diseases. Patients were considered to have taken medication if it was administered within 24 hours before an accidental fall. Multiple logistic regression analysis was used to evaluate the risk of accidental fall. Results Multivariate analysis showed that the adjusted odds ratios (OR) for each medication (with 95% confidence intervals) were: trazodone (OR, 0.47 [0.27–0.80]), quetiapine (OR, 1.06 [0.46–2.46]), and risperidone (OR, 0.82 [0.41–1.63]). Conclusion The association of risperidone and quetiapine with accidental falls was unclear. Interestingly, however, trazodone may help reduce the risk, which makes it a potential pharmacologic treatment option for insomnia in patients at high risk for accidental falls.
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spelling doaj.art-2d9c195bc2e140398421939b5835eb022022-12-22T12:22:50ZengWileyNeuropsychopharmacology Reports2574-173X2022-12-0142453253710.1002/npr2.12297Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control studyYoshihito Shimizu0Masatoshi Taga1Yoshimitsu Takahashi2Yasuhiko Yamamoto3Togen Masauji4Department of Pharmacy Kanazawa Medical University Hospital Kahoku JapanDepartment of Pharmacy Kanazawa Medical University Hospital Kahoku JapanDepartment of Pharmacy Kanazawa Medical University Hospital Kahoku JapanMedical Safety Division Kanazawa Medical University Hospital Kahoku JapanDepartment of Pharmacy Kanazawa Medical University Hospital Kahoku JapanAbstract Aim No consensus has been reached on the association between the risk of falls and antipsychotic and antidepressant drug use. In this study, we evaluated the risk of falls with trazodone, risperidone, and quetiapine, which are recommended for use at Kanazawa Medical University Hospital. Methods We reviewed all patients who were admitted to Kanazawa Medical University Hospital between January 1st and December 31st, 2018. We excluded those aged <20 years and those admitted to pediatric, intensive care, and psychiatric wards. Finally, 9273 patients were included. We reviewed the incidence in these patients of accidental falls reported to the medical safety department. We noted whether these patients received trazodone, quetiapine, or risperidone. We also observed whether they were taking a benzodiazepine receptor agonist, which is a known risk factor. We further examined each patient's age, sex, the department they were visiting, and their diseases. Patients were considered to have taken medication if it was administered within 24 hours before an accidental fall. Multiple logistic regression analysis was used to evaluate the risk of accidental fall. Results Multivariate analysis showed that the adjusted odds ratios (OR) for each medication (with 95% confidence intervals) were: trazodone (OR, 0.47 [0.27–0.80]), quetiapine (OR, 1.06 [0.46–2.46]), and risperidone (OR, 0.82 [0.41–1.63]). Conclusion The association of risperidone and quetiapine with accidental falls was unclear. Interestingly, however, trazodone may help reduce the risk, which makes it a potential pharmacologic treatment option for insomnia in patients at high risk for accidental falls.https://doi.org/10.1002/npr2.12297accidental fallinsomniaquetiapinerisperidonetrazodone
spellingShingle Yoshihito Shimizu
Masatoshi Taga
Yoshimitsu Takahashi
Yasuhiko Yamamoto
Togen Masauji
Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
Neuropsychopharmacology Reports
accidental fall
insomnia
quetiapine
risperidone
trazodone
title Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
title_full Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
title_fullStr Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
title_full_unstemmed Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
title_short Risk assessment of accidental falls in patients taking trazodone, quetiapine, or risperidone for insomnia: A single‐center, case–control study
title_sort risk assessment of accidental falls in patients taking trazodone quetiapine or risperidone for insomnia a single center case control study
topic accidental fall
insomnia
quetiapine
risperidone
trazodone
url https://doi.org/10.1002/npr2.12297
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