Older antipsychotic medications appear to be no safer than newer antipsychotic drugs in elderly people, and should not be used to replace the newer drugs without careful consideration.That’s the conclusion of a study appearing in the Dec. 1 issue of the New England Journal of Medicine.The issue of replacing one generation of drugs for another has become a concern since April of 2005, when the U.S. Food and Drug Administration started requiring that newer antipsychotic drugs carry a “black-box” warning. The warning states that these medications nearly doubled the risk of death among older patients compared with a placebo.Older drugs do not carry such a warning -- but probably only because the FDA didn’t have the necessary data, pointed out lead researcher Dr. Philip Wang, a psychiatrist and epidemiologist at Brigham and Women’s Hospital and an assistant professor of psychiatry, medicine and health-care policy at Harvard Medical School, both in Boston.Some experts have worried that clinicians are interpreting the absence of data as an absence of risk and are prescribing older drugs because they think they are safer.
