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Title: All Antipsychotics Increase Risk of Stroke, Patients With Dementia at Double Risk
URL: http://www.pslgroup.com/dg/22A336.htm
Doctor's Guide
August 29, 2008

LONDON -- August 29, 2008 -- All drugs used to treat psychosis are linked to an increased risk of stroke, and dementia sufferers are at double the risk, according to a study published today online at BMJ (British Medical Journal).

Previous research has shown that atypical antipsychotic drugs can increase the chances of patients having a stroke. But the risk of stroke associated with typical antipsychotics, and whether the risk differs in people with and without dementia, is not known.

Concerns about an increased risk of stroke among people taking atypical antipsychotic drugs were first raised in 2002, particularly in people with dementia. In 2004, the UK's Committee on Safety of Medicines recommended that these drugs should not be used in people with dementia, despite a lack of clear evidence.

A team of researchers from the London School of Hygiene and Tropical Medicine, London, United Kingdom, examined data from the General Practice Research Database (GPRD), which contains the clinical information of more than 6 million patients registered at over 400 general practices in the United Kingdom.

They assessed the effect of exposure to antipsychotic medication on the incidence of stroke in 6,790 patients, with a recorded incident of stroke and at least 1 prescription of any antipsychotic between January 1988 and the end of 2002.

The authors found that during periods when patients were receiving an antipsychotic drug, they were 1.7 times more likely to have a stroke; whereas people with dementia were 3.5 times more likely to have a stroke while taking any antipsychotic.

The likelihood of having a stroke was slightly higher for people taking atypical antipsychotics compared with people taking typical antipsychotics.

The study did not look at the specific mechanisms linking antipsychotics and stroke or why the risk is greater with atypical antipsychotics.

Previously, the risk of stroke associated with typical antipsychotics was unclear, said the authors, but "we have established that all types of antipsychotics carry an increased risk, although the risk might be somewhat higher with the atypical drugs."

"We reaffirm that the risks associated with antipsychotic use in patients with dementia generally outweigh the potential benefits, and in this patient group, use of antipsychotic drugs should be avoided wherever possible."

SOURCE: BMJ

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