Doctors should be aware that antipsychotics are potentially toxic, particularly in older patients and those with dementia, say the authors of a large meta-analysis.

German researchers examined 341 randomised controlled trials comparing second-generation antipsychotics with placebo to determine whether serious adverse events were more common among those on the drugs.

Looking only at somatic serious adverse events, they found these were 24% more likely in patients on antipsychotics than in those on placebo, the authors reported in the Lancet Psychiatry.

They calculated that between 1.6% and 2% of patients taking the drugs had a somatic serious adverse event compared with between 1.4% and 1.7% of those on placebo.