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Large-scale observational studies have highlighted the risk of ischemic stroke with centrally acting antidopaminergic antipsychotics, especially in elderly patients and those with dementia
.
Although antipsychotic drugs also block various other receptors (muscarinic, histamine, serotonin, epinephrine), the mechanism by which these drugs may lead to stroke may be related to this dopamine antagonism
Large-scale observational studies have highlighted the risk of ischemic stroke with centrally acting antidopaminergic antipsychotics, especially in elderly patients and those with dementia
stroke
Eligible participants who had their first ischemic stroke between 2012 and 2016 were assessed for each patient's risk period (day 14 to day 1 before stroke) and three matched reference periods (day -70 to day 1) ADA reimbursement frequency on days 57, 56 to 43, and 42 to 29)
.
The primary outcome measure, the association between ADA use and ischemic stroke risk, was assessed by estimating the odds ratio of exposure assessed in stroke patients and controls
Of the 2612 patients identified who developed stroke, 1250 received ADA during the risk period and 1060 received ADA during the reference period
.
The risk was increased by 212% (OR=3.
The risk was increased by 212% (OR=3.
Proportion of people who started ADA treatment within 70 days before ischemic stroke
Proportion of people who started ADA treatment within 70 days before ischemic strokeBy ADA stratified analysis, adjusted ratios were 2.
51 (2.
18 to 2.
88) for domperidone, 3.
62 (3.
11 to 4.
23) for dexmedetomidine, and 3.
53 (2.
62 to 4.
76) for metoclopramide
.
Sensitivity analysis indicated that the risk would be higher during the first few days of use
By ADA stratified analysis, adjusted ratios were 2.
Taken together, this self-controlled study reports an increased risk of ischemic stroke with recent ADA use
references:
Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study.
Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study.
BMJ 2022;376:e066192 Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study.
BMJ 2022;376:e066192 leave a message here
