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Concern About Increased Stroke Risk With Risperidone Unfounded: Presented at CINP

By Jill Stein

PARIS, FRANCE -- June 21, 2004 -- Researchers report that there is no evidence of an increased stroke risk in elderly patients with dementia who are treated with risperidone versus other antipsychotics.

Chris Kozma, PhD, Adjunct Professor of Pharmacy, University of South Carolina in West Columbia, presented the findings here on June 21st at the XXIV Collegium Internationale Neuro-psychopharmacologicum.

His team evaluated the relative odds of stroke-related cerebrovascular events in patients treated with risperidone, olanzapine, quetiapine, and haloperidol while also using benzodiazepines as a non-antipsychotic control group.

"Low-dose antipsychotics are often prescribed to patients with dementia to help control behavioral and psychological symptoms," Dr. Kozma observed. "However, recent concern that treatment of elderly patients with atypical antipsychotics may be associated with an increased risk of cerebrovascular events has led to labeling changes."

Dr. Kozma and colleagues analysed pooled health care data from the 1999-2002 Medicaid database consisting of from approximately 8 million Medicaid enrollees from multiple states. The primary outcome variable was incidence of acute inpatient admission for a stroke-related event within 90 days of initiating treatment with the index medication.

Overall, 2898 patients were taking risperidone, 4,093 patients were on olanzapine, 688 were on quetiapine, 1,259 were on haloperidol, and 9,334 were on benzodiazepines.

No differences were found between risperidone and olanzapine (odds ratio [OR] 1.05, P =.86), and risperidone versus quetiapine (OR 0.66, P =.44). The risperidone versus haloperidone comparison was significant with haloperidone having greater odds of stroke-related events than risperidone (OR 1.91, P =.045).

The benzodiazepine control group had a significantly greater odds of stroke-related events compared to risperidone (OR 1.96, P =.001) and a significantly greater risk compared to all atypical antipsychotics (OR 2.05, P <.001).

"Overall, the results indicate that risperidone treatment does not confer a greater risk of stroke-related events than treatment with other types of antipsychotics or benzodiazepines in elderly demented patients in the 90 days following the start of treatment," Dr. Kozma said. "In fact, after controlling for potentially confounding variables, patients in the benzodiazepine group had a greater risk of a stroke-related event than patients using atypical antipsychotics."

The study was supported by Janssen Medical Affairs in Titusville, New Jersey.


[Presentation title: "Absence of Risperidone-Related Increased Stroke-Risk Among Dementia Patients." Abstract #P01.278]

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