|
Chlorpromazine |
Haloperidol |
Quetiapine |
Risperidone |
Perphenazine |
Olanzapine |
Incident users |
9,740 |
24,900 |
83,402 |
129,046 |
14,427 |
151,646 |
Prescriptions |
36,283 |
123,494 |
591,804 |
1,051,896 |
68,436 |
1,196,400 |
Person-years (p-y) |
2,079 |
7,908 |
37,759 |
70,934 |
5,064 |
81,484 |
Principal inpatient or first-listed emergency department SD/VAs |
14 |
53 |
86 |
271 |
11 |
276 |
Incidence rate per 1,000 p-y
(95 % confidence interval) |
6.7
(3.7-11.3) |
6.7
(5.0-8.8) |
2.3
(1.8-2.8) |
3.8
(3.4-4.3) |
2.2
(1.1-3.9) |
3.4
(3.0-3.8) |
Unadjusted incidence rate ratio
(95% confidence interval) |
2.0
(1.1-3.4) |
2.0
(1.5-2.7) |
0.7
(0.5-0.9) |
1.1
(1.0-1.3) |
0.6
(0.3-1.2) |
reference |
USER-LEVEL VARIABLES |
Female sex |
36.3% |
51.7% |
64.8% |
60.1% |
72.3% |
57.7% |
Age, in years |
< 35 |
11.0% |
11.1% |
14.0% |
12.7% |
10.4% |
12.8% |
35-44 |
29.6% |
28.2% |
35.1% |
30.0% |
28.6% |
32.1% |
45-54 |
24.7% |
24.0% |
27.7% |
25.4% |
26.0% |
26.3% |
55-64 |
16.9% |
16.6% |
13.3% |
15.7% |
18.2% |
14.9% |
65-74 |
17.8% |
20.0% |
9.9% |
16.2% |
16.8% |
13.9% |
Race |
White |
45.8% |
44.8% |
54.3% |
47.0% |
35.6% |
48.2% |
Non-White |
54.2% |
55.2% |
45.7% |
53.0% |
64.4% |
51.8% |
PRESCRIPTION-LEVEL VARIABLES |
Nursing home residence |
10.6% |
16.9% |
11.5% |
21.0% |
3.2% |
15.3% |
Diagnoses ever in past |
Agranulocytosis (Neutropenia) |
3.8% |
2.2% |
1.9% |
1.8% |
1.1% |
2.1% |
Alcohol abuse |
19.5% |
16.5% |
21.1% |
16.3% |
9.1% |
19.1% |
Anemia |
35.2% |
31.8% |
30.8% |
33.3% |
29.9% |
32.7% |
Arrhythmia / Conduction Disorders |
19.7% |
17.4% |
18.2% |
19.4% |
15.7% |
18.7% |
Asthma / COPD |
35.4% |
32.0% |
37.8% |
32.8% |
37.9% |
36.1% |
Bulimia |
0.4% |
0.2% |
0.7% |
0.3% |
0.3% |
0.4% |
Cancer |
21.9% |
16.4% |
20.2% |
18.6% |
16.7% |
19.2% |
Cerebral Palsy |
2.6% |
1.8% |
1.8% |
2.9% |
0.9% |
2.0% |
Cerebrovascular Disease |
15.4% |
18.8% |
16.7% |
20.4% |
14.3% |
18.5% |
Coronary Artery Disease |
22.6% |
20.7% |
22.7% |
24.2% |
23.1% |
23.4% |
Diabetes |
27.2% |
28.2% |
27.7% |
30.0% |
31.0% |
25.6% |
Emesis / Nausea |
22.8% |
15.3% |
21.5% |
15.9% |
14.9% |
16.8% |
Enuresis |
9.9% |
11.0% |
11.9% |
12.3% |
9.6% |
11.2% |
Epilepsy / Convulsions |
22.8% |
20.6% |
19.4% |
21.4% |
9.9% |
18.6% |
HIV / AIDS |
9.1% |
5.0% |
7.5% |
6.9% |
3.1% |
10.3% |
Headache |
27.4% |
22.9% |
35.8% |
26.8% |
32.8% |
30.1% |
Heart Failure / Cardiomyopathy |
16.4% |
15.6% |
13.7% |
16.2% |
13.4% |
14.6% |
Hereditary and Degenerative Diseases of the Central Nervous System |
11.1% |
17.2% |
14.8% |
15.0% |
6.1% |
13.7% |
Hiccough (Non-psychogenic) |
7.9% |
0.2% |
0.1% |
0.1% |
0.1% |
0.2% |
Hypercholesterolemia |
33.6% |
30.0% |
37.1% |
34.4% |
38.2% |
34.8% |
Hypertension |
47.9% |
48.0% |
48.3% |
49.9% |
52.4% |
48.2% |
Hyperthyroidism / Thyrotoxicosis |
4.5% |
3.6% |
4.9% |
4.2% |
4.2% |
4.5% |
Hypothyroidism |
16.4% |
16.5% |
20.2% |
18.6% |
17.7% |
17.7% |
Kidney Disease |
20.8% |
16.3% |
17.1% |
16.8% |
14.5% |
16.8% |
Liver Disease |
25.2% |
19.4% |
24.0% |
20.4% |
17.7% |
23.7% |
Neuropathic Pain |
22.8% |
17.0% |
27.8% |
20.9% |
25.8% |
23.2% |
Obesity |
11.4% |
10.8% |
16.8% |
13.5% |
12.1% |
10.2% |
Organic Psychotic Conditions |
19.8% |
27.3% |
24.9% |
28.2% |
8.7% |
25.4% |
Dementias |
4.0% |
10.4% |
8.0% |
13.2% |
2.8% |
9.7% |
Alcohol-induced mental disorders |
4.1% |
4.6% |
5.0% |
4.5% |
1.9% |
5.4% |
Drug-induced mental disorders |
6.2% |
4.3% |
7.2% |
4.5% |
2.7% |
6.5% |
Transient mental disorders |
6.4% |
10.8% |
9.0% |
10.3% |
3.9% |
9.6% |
Persistent mental disorders |
5.7% |
12.8% |
9.2% |
14.3% |
3.3% |
11.1% |
Other Non-psychotic Mental Disorders, Mental Retardation |
14.4% |
11.1% |
8.9% |
13.9% |
3.4% |
9.4% |
Other Non-psychotic Mental Disorders, Non-Mental Retardation |
61.6% |
58.2% |
75.9% |
67.7% |
49.1% |
69.3% |
Anxiety, dissociative, and somatoform disorders |
38.4% |
32.2% |
53.6% |
43.3% |
41.6% |
45.7% |
Personality disorders |
10.6% |
9.8% |
15.1% |
10.1% |
5.7% |
10.4% |
Adjustment reaction |
14.0% |
10.5% |
22.1% |
17.3% |
10.7% |
18.0% |
Depressive disorder |
32.7% |
29.0% |
52.2% |
43.0% |
31.8% |
45.8% |
Other |
48.8% |
44.5% |
53.8% |
47.7% |
34.5% |
51.3% |
Other Psychoses |
62.2% |
76.1% |
81.1% |
77.9% |
48.0% |
78.0% |
Schizophrenic disorders |
32.2% |
51.9% |
30.7% |
36.3% |
21.2% |
38.0% |
Episodic mood disorders |
42.2% |
37.8% |
66.8% |
55.6% |
38.0% |
59.1% |
Delusional disorders |
2.7% |
5.1% |
3.7% |
4.8% |
1.8% |
4.3% |
Other nonorganic psychoses |
22.1% |
36.3% |
25.1% |
30.8% |
13.2% |
28.9% |
Pervasive developmental disorders |
1.7% |
1.2% |
0.9% |
1.4% |
0.5% |
0.9% |
Porphyrin Metabolic Disorders |
0.1% |
<0.1% |
0.1% |
<0.1% |
0.1% |
0.1% |
Premenstrual Tension Syndrome |
0.3% |
0.2% |
0.7% |
0.4% |
0.3% |
0.4% |
Pulmonary Circulation Disorders |
3.7% |
3.0% |
3.3% |
3.2% |
2.7% |
3.1% |
Restless Legs Syndrome |
0.3% |
0.4% |
0.7% |
0.4% |
0.3% |
0.4% |
Rheumatoid Arthritis and Other Inflammatory Polyarthropathies |
15.5% |
13.6% |
20.0% |
17.3% |
25.9% |
18.9% |
Smoking |
16.3% |
13.6% |
17.6% |
11.7% |
10.9% |
14.1% |
Substance Abuse |
31.7% |
26.5% |
35.3% |
25.0% |
19.3% |
31.1% |
Syndrome of Inappropriate Secretion of Antidiuretic Hormone |
0.4% |
0.4% |
0.3% |
0.3% |
0.2% |
0.3% |
Tardive Dyskinesia |
0.6% |
1.1% |
0.9% |
0.6% |
0.2% |
0.8% |
Valvular Heart Disease |
12.9% |
10.2% |
12.0% |
11.5% |
11.3% |
11.8% |
Drugs used ever in past |
ACEI / ATIIRB |
25.0% |
23.8% |
24.0% |
24.6% |
28.1% |
23.1% |
Anorexiants / Antiobesity |
0.7% |
0.3% |
1.0% |
0.6% |
0.6% |
0.6% |
Antiadrenergic |
8.3% |
6.1% |
6.9% |
5.5% |
5.2% |
6.0% |
Antiarrhythmic, Class I, Oral (excluding phenytoin) |
0.4% |
0.3% |
0.3% |
0.3% |
0.3% |
0.3% |
Antiarrhythmic, Class III, Oral |
0.5% |
0.5% |
0.3% |
0.5% |
0.3% |
0.5% |
Antidiabetic |
17.4% |
17.7% |
16.6% |
18.0% |
19.8% |
13.8% |
Beta Blocker, Systemic |
21.2% |
17.9% |
21.4% |
18.7% |
19.6% |
19.0% |
Bronchodilator, Adrenergic |
29.0% |
22.4% |
35.0% |
26.9% |
33.2% |
29.9% |
CCB, Non-verapamil |
17.7% |
17.8% |
16.1% |
17.2% |
21.1% |
17.3% |
CCB, Verapamil |
3.2% |
2.8% |
3.5% |
2.9% |
3.9% |
3.0% |
Corticosteroid, Inhaled |
12.2% |
8.7% |
16.8% |
12.0% |
15.1% |
13.6% |
Corticosteroid, Oral |
19.2% |
12.7% |
22.1% |
15.3% |
19.1% |
17.0% |
Digoxin |
4.0% |
3.5% |
2.3% |
3.2% |
2.2% |
2.7% |
Diuretic, Loop |
14.2% |
13.3% |
14.9% |
14.1% |
14.5% |
12.7% |
Diuretic, Thiazide |
15.1% |
13.8% |
18.2% |
16.1% |
20.7% |
15.8% |
Immunosuppressant for Organ Transplantation |
0.7% |
0.4% |
0.4% |
0.4% |
0.3% |
0.4% |
Lipid Lowering Agent |
21.0% |
18.0% |
23.7% |
21.6% |
26.9% |
22.4% |
Nitrate |
10.5% |
9.1% |
10.2% |
10.1% |
12.1% |
9.8% |
Thyroid Hormone |
8.4% |
9.1% |
11.4% |
9.5% |
8.8% |
8.7% |
Vasodilator, Non-nitrate |
1.6% |
1.0% |
0.6% |
0.7% |
0.4% |
0.7% |
Warfarin |
4.2% |
3.8% |
3.4% |
3.6% |
2.0% |
3.4% |
Xanthine Derivative |
4.1% |
3.3% |
3.9% |
3.5% |
6.2% |
4.0% |
Drugs used currently |
Antiarrhythmic, Class Ia |
0.1% |
0.1% |
<0.1% |
0.1% |
0.1% |
<0.1% |
Antiarrhythmic, Classes Ib & Ic* |
** |
<0.1% |
0.1% |
<0.1% |
<0.1% |
<0.1% |
Antiarrhythmic, Class III * |
0.3% |
0.3% |
0.2% |
0.3% |
0.1% |
0.2% |
Antidepressant, Cyclic and Related |
21.5% |
16.6% |
22.3% |
20.0% |
76.0% |
20.1% |
Antiemetic 5-hydroxytryptamine 3 Receptor Antagonist |
1.0% |
0.2% |
0.1% |
0.1% |
0.2% |
0.1% |
Anti-infective, Amantadine / Foscarnet |
0.5% |
1.0% |
0.6% |
0.5% |
0.5% |
0.6% |
Anti-infective, Azole Antifungal |
3.0% |
1.5% |
1.7% |
1.3% |
1.6% |
1.8% |
Anti-infective, Clindamycin |
0.6% |
0.4% |
0.5% |
0.4% |
0.4% |
0.4% |
Anti-infective, Macrolide |
5.2% |
2.8% |
4.0% |
3.1% |
4.3% |
3.7% |
Anti-infective, Pentamidine |
<0.1% |
** |
<0.1% |
<0.1% |
- |
<0.1% |
Anti-infective, Quinolone |
6.2% |
4.3% |
4.3% |
3.9% |
4.4% |
4.2% |
Anti-infective, TMP-SMX |
4.0% |
2.7% |
2.1% |
2.1% |
2.6% |
2.7% |
Aspirin |
3.8% |
4.4% |
4.1% |
4.6% |
5.3% |
4.1% |
Beta-blocker, Systemic |
11.2% |
10.0% |
10.1% |
9.7% |
9.6% |
9.2% |
Bronchodilator, Adrenergic* |
10.8% |
8.0% |
11.1% |
9.0% |
12.6% |
10.5% |
CCB* |
** |
<0.1% |
<0.1% |
<0.1% |
<0.1% |
<0.1% |
CCB, Non-verapamil |
9.1% |
10.1% |
7.9% |
8.9% |
10.7% |
8.8% |
CCB, Verapamil |
1.1% |
1.2% |
1.3% |
1.1% |
1.9% |
1.1% |
Chloral Hydrate |
0.5% |
0.1% |
0.1% |
0.1% |
0.1% |
0.1% |
Cyclooxygenase-2 Inhibitor |
7.5% |
6.2% |
10.9% |
9.3% |
12.6% |
10.8% |
Diuretic, Loop |
6.8% |
6.5% |
6.4% |
6.9% |
6.4% |
5.9% |
Diuretic, Potassium-sparing |
3.3% |
2.7% |
2.7% |
2.4% |
3.3% |
2.2% |
Diuretic, Thiazide |
5.6% |
5.9% |
6.9% |
6.5% |
8.9% |
6.2% |
Droperidol |
** |
** |
<0.1% |
<0.1% |
- |
<0.1% |
Ephedrine / PPA / Pseudoephedrine |
2.8% |
1.9% |
2.9% |
2.5% |
6.7% |
2.8% |
Epinephrine |
0.1% |
<0.1% |
0.1% |
0.1% |
0.1% |
0.1% |
Famotidine |
4.4% |
4.3% |
2.5% |
3.0% |
2.9% |
2.8% |
Felbamate / Fosphenytoin |
0.2% |
0.1% |
<0.1% |
<0.1% |
- |
<0.1% |
Galantamine |
0.1% |
0.1% |
0.3% |
0.3% |
<0.1% |
0.2% |
Hydroxychloroquine / Chloroquine / Mefloquine |
0.2% |
0.1% |
0.3% |
0.2% |
0.4% |
0.2% |
Hydroxyzine |
5.6% |
3.6% |
5.0% |
4.0% |
5.1% |
3.9% |
Magnesium Supplement |
0.4% |
0.3% |
0.3% |
0.2% |
0.4% |
0.3% |
Meperidine |
0.2% |
0.1% |
0.1% |
0.1% |
0.1% |
0.1% |
Methadone |
0.7% |
0.3% |
0.6% |
0.2% |
0.4% |
0.4% |
NSAID |
10.4% |
8.2% |
12.2% |
9.0% |
18.9% |
10.4% |
Octreotide |
0.1% |
<0.1% |
<0.1% |
<0.1% |
** |
<0.1% |
Phentermine / Sibutramine |
** |
** |
<0.1% |
<0.1% |
<0.1% |
<0.1% |
Potassium Supplement |
4.6% |
4.7% |
4.1% |
4.6% |
4.6% |
3.9% |
Quinine |
0.8% |
0.5% |
0.6% |
0.4% |
1.3% |
0.5% |
Sildenafil |
1.7% |
0.6% |
1.2% |
1.1% |
0.8% |
2.9% |
Tacrolimus |
0.1% |
0.1% |
<0.1% |
0.1% |
** |
<0.1% |
Tamoxifen |
0.3% |
0.3% |
0.2% |
0.2% |
0.4% |
0.2% |
Tizanidine |
0.7% |
0.2% |
0.9% |
0.4% |
0.9% |
0.7% |
COPD = chronic obstructive pulmonary disease; HIV = human immunodeficiency virus; AIDS = acquired immune deficiency syndrome; ACEI = angiotensin-converting enzyme inhibitor; ATIIRB = angiotensin-II receptor blocker; CCB = calcium channel blocker; TMP-SMX = trimethoprim-sulfamethoxazole; PPA = phenylpropanolamine; NSAID = nonsteroidal anti-inflammatory drug