The atypical antipsychotics quetiapine (Seroquel), risperidone (Risperdal), and olanzapine (Zyprexa)—commonly prescribed off-label to help manage behavioral symptoms of dementia—are associated with increased risk of acute kidney injury in older adults, suggests a study published last week in the Annals of Internal Medicine.

Researchers found that participants prescribed quetiapine, risperidone, or olanzapine were more than 1.5 times more likely to be hospitalized with an acute kidney injury within 90 days of receiving the prescriptions than participants not prescribed one of the drugs in the population-based cohort study.

In addition, the medications were associated with an increased risk of hypotension (RR 1.91) and acute urinary retention (RR 1.98) in older adults compared with nonusing older adults. Among older adults prescribed one of the medications, death by any cause was significantly higher than among adults who were not prescribed the medications (RR 2.39 for recipients).

“The findings support current safety concerns about the use of these drugs in older adults,” researchers wrote in their conclusion.

Researchers came to their findings after evaluating adverse outcomes of 97,777 outpatients 65 and older in Ontario, Canada, who received a new prescription for quetiapine, risperidone, or olanzapine between 2003 and 2012. The study also included 97,777 additional older adults who were not prescribed the drugs.