Research Activities April 2013, No. 392
Antipsychotic use among the elderly boosts risk of stroke
Warnings of increased risk of death and vascular adverse events associated with off-label use of antipsychotics among the elderly surfaced in 2002. Yet, considerable use of antipsychotics among the elderly has persisted, due in part to the lack of pharmacological alternatives for management of behavioral and psychological symptoms of dementia. These medications may boost the risk of stroke, suggests a new study. It found that the odds of stroke were 1.8 times higher during time exposed to antipsychotic medications than during time unexposed. This effect was found to be greater among older veterans.
The researchers analyzed data from the Veterans Health Administration on inpatient hospitalizations for ischemic stroke between 2002 and 2007. The study included 511 stroke cases; 85 percent had taken antipsychotic medications in the 30 days prior to their stroke and 15 percent had taken them 90 to 120 days before their stroke. The researchers recommend that antipsychotic therapy among the elderly be initiated only after alternative strategies of dealing with symptoms of behavioral and psychological symptoms of dementia have been fully investigated. Their study was supported in part by AHRQ (T32 HS000011).
See "Age, antipsychotics, and the risk of ischemic stroke in the Veterans Health Administration," by Shirley Wang, Ph.D., Crystal Linkletter, Ph.D., David Dore, Ph.D., and others in Stroke 43, pp. 28-31, 2012.