Introduction Recent research on elderly patients suggests that use of antipsychotics may increase risk of hospitalization or death. These drugs have significant side effect burdens, many of them relating to cardiovascular health. Few observational epidemiologic studies looked at rates of use of antipsychotic medication and associated mortality in elderly. The aim of this study was to determine prevalence of antipsychotic use in elderly patients and to determine mortality rates of patients treated with antipsychotics and to compare these data with the mortality rates for the general population.

Methods We conducted a retrospective cohort study involving 26,639 patients 65 years of age or older who had drug insurance benefits in Gdansk voivodship and who began receiving a antipsychotic medication between 2008 and 2012. Prevalence proportions for the use of antipsychotics and age-standardized death rates (SDRs) and 95% confidence intervals (CIs) were calculated in population using antipsychotics and in matched general population.

Results The prevalence of getting a prescription for an antipsychotic was 1.9%. Women were prescribed more frequently than men: 2.1% vs. 1,6%. Rates of antipsychotic utilization increase with increasing age. The lowest number of refunded prescriptions was observed in 2012, possibly owing to a change in the drug refund scheme.

The SDR for antipsychotic users was 316.7 per 1000, 95% CI 310.5 - 322.8. The SDRs for general population was 7 times lower (43.1 per 1000, 95% CI 42.8 – 43.4). The differences in mortality between population with neuroleptics and neuroleptics dropped in 2012 when the change in the drug refund scheme occurred.

Conclusions These results suggest that results suggest that attention should be paid to elderly patients with antipsychotics with regard to proper qualification to therapy. Overuse of antipsychotic may be prevented by adequate reimbursement regulations.