Antipsychotic medications are critical in managing schizophrenia and other related disorders, but they come with various side effects, one of which is the increased risk of pneumonia. A comprehensive study published in JAMA Psychiatry in June 2024 (article) offers valuable insights into the comparative pneumonia risks associated with different antipsychotic medications. Let’s delve into the key findings and their implications for clinical practice.

Study Overview

The study, led by Jurjen J. Luykx and colleagues, examined the pneumonia risk associated with specific antipsychotics in patients with schizophrenia. The research leveraged data from nationwide Finnish registers, encompassing 61,889 individuals diagnosed with schizophrenia, tracked from 1996 to 2017. This extensive dataset allowed for a detailed analysis of various factors influencing pneumonia risk, including medication type, dosing, and polypharmacy.

Following three antipsychotics were ranked higher:

(1) High-dose Quetiapine (≥440 mg/day): AHR, 1.78 (95% CI, 1.22-2.60)

(2) High-dose Clozapine (≥180 mg/day): AHR, 1.44 (95% CI, 1.22-1.71)

(3) Medium-dose Clozapine (180 to <330 mg/day): AHR, 1.43 (95% CI, 1.18-1.74)

(4) High-dose Olanzapine (>11 mg/day): was also found to increase pneumonia risk (AHR, 1.29; 95% CI, 1.05-1.58).