Risk of Cerebrovascular Accident Associated with Use of Antipsychotics: Population‐Based Case–Control Study

Laredo, Leonor; Vargas, Emilio; Blasco, Antonio Javier; Aguilar, M.A.; Moreno, A.; Portolés, Antonio

doi:10.1111/j.1532-5415.2011.03479.x

Cited by 32 publications

(26 citation statements)

References 24 publications

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“…From studies targeting other disease populations, such as those with schizophrenia and dementia, the risk of stroke associated with the use of antipsychotic agents was found to be equivocal. Some studies reported no association between the use of either typical or atypical antipsychotic agents and the risk of stroke (37), whereas others reported that the use of typical antipsychotic agents was associated with an increased risk of stroke (38)(39)(40), and still others reported this association for atypical antipsychotic agents (41). This finding of no significant association may also be related to the distinctive effects of different individual antipsychotic agents on the risk of stroke.…”

Section: Discussionmentioning

confidence: 99%

A reduced risk of stroke with lithium exposure in bipolar disorder: a population‐based retrospective cohort study

et al. 2015

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Section: Discussionmentioning

confidence: 99%

A reduced risk of stroke with lithium exposure in bipolar disorder: a population‐based retrospective cohort study

et al. 2015

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“…The records on drug exposure and diagnoses have repeatedly been validated and proven to be of high quality [17,18]. The CPRD has been the data source for several observational studies on antipsychotic drug use [19][20][21] and on seizures [22][23][24][25]. This study was approved by the Independent Scientific Advisory Committee for Medicines and Healthcare products Regulatory Agency research (London, UK).…”

Section: Study Design and Data Sourcementioning

confidence: 99%

Antipsychotic Drug Use and the Risk of Seizures: Follow-up Study with a Nested Case–Control Analysis

et al. 2015

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Current use of medium-to-high potency first-generation antipsychotic drugs was associated with a 2.5-fold increased risk of seizures compared with non-use of antipsychotic drugs in patients with affective disorders. In these patients, current use of all other antipsychotic drug subclasses was not associated with seizures. In patients with dementia, current and past use of all antipsychotic drug subclasses, except amisulpride, aripiprazole, risperidone, or sulpiride, was associated with an increased risk of seizures.

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“…A self-controlled case-crossover study [5] demonstrated that both FGAs and SGAs were associated with the risk of stroke among elderly patients. In contrast, a population-based case-control study [7] showed that only the use of FGAs was slightly associated with the risk of stroke but not with the use of SGAs. Thus, the above studies showed inconsistent findings.…”

Section: Introductionmentioning

confidence: 96%

Antipsychotic medications and stroke in schizophrenia: A case-crossover study

Chen

Liu

et al. 2017

PLoS ONE

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BackgroundThe association between antipsychotic use and the risk of stroke in schizophrenic patients is controversial. We sought to study the association in a nationwide cohort with schizophrenia.MethodsUsing a retrospective cohort of patients with schizophrenia (N = 31,976) derived from the Taiwan National Health Insurance Research Database, 802 new-onset cases of stroke were identified within 10 years of follow-up (from 2000 through 2010). We designed a case-crossover study using 14-day windows to explore the risk factors of stroke and the association between antipsychotic drugs and the risk of stroke. We analyzed the risks of individual antipsychotics on various subgroups of stroke including ischemic, hemorrhagic, and other strokes, and the risks based on the antipsychotic receptor-binding profile of each drug.ResultsUse of any second-generation antipsychotic was associated with an increased risk of stroke (adjusted risk ratio = 1.45, P = .009) within 14 days while the use of any first-generation antipsychotic was not. Intriguingly, the use of any second-generation antipsychotic was associated with ischemic stroke but not hemorrhagic stroke. The antipsychotic receptor-binding profile analysis showed that the antihistamine 1 receptor was significantly associated with ischemic stroke (adjusted risk ratio = 1.72, P = .037), and the sensitivity analysis based on the 7-day window of exposure validated the association (adjusted risk ratio = 1.87, P = .015).ConclusionsUse of second-generation antipsychotic drugs appeared to be associated with an increased risk of ischemic stroke in the patients studied, possibly mediated by high affinity for histamine-1 receptor blockade. Further research regarding the underlying biological mechanism and drug safety is suggested.

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Risk of Cerebrovascular Accident Associated with Use of Antipsychotics: Population‐Based Case–Control Study

Abstract: No reasons were found to question the cerebrovascular safety of atypical antipsychotics in older adults with dementia. The typical antipsychotics appear to be associated with a higher risk of CVA, although the risk disappears after use is discontinued.

Cited by 32 publications

References 24 publications

A reduced risk of stroke with lithium exposure in bipolar disorder: a population‐based retrospective cohort study

A reduced risk of stroke with lithium exposure in bipolar disorder: a population‐based retrospective cohort study

Antipsychotic Drug Use and the Risk of Seizures: Follow-up Study with a Nested Case–Control Analysis

Antipsychotic medications and stroke in schizophrenia: A case-crossover study

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