Stroke Risk Varies With Use of Different Antipsychotics

Beginning a decade ago, researchers noticed an association between use of antipsychotics among elderly patients and an increased risk of stroke. Antipsychotics are given to older patients to treat not only psychosis, but also depression, anxiety, insomnia, and agitation. Antipsychotics act primarily on the D2 subtype of the dopamine receptors, but on others as well. Understanding the mechanisms by which these medications influence stroke risk might lead to safer treatment practices.

To shed more light on this issue, Susan Shur-Fen Gau, M.D., Ph.D. a professor of psychiatry at the National Taiwan University Hospital and College of Medicine, and colleagues, looked at insurance data on 14,584 patients to link stroke risk with receptor binding profiles. They found that patients taking antipsychotics had an odds ratio of 1.60 of increased stroke risk, said Gau in the March 1 Biological Psychiatry. “The use of antipsychotics with a high binding affinity of M1 muscarinic and α2 adrenergic receptors was associated with a greater risk of stroke than the use of other types of antipsychotics,” wrote Gau. “An increased risk of stroke with antipsychotic use was noted in the patients who were older and/or who suffered from dementia.”

To read more about the use of antipsychotics in individuals with dementia, see Psychiatric News here and here. 

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