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Journal of the American Geriatrics Society 2011-Jul

Risk of cerebrovascular accident associated with use of antipsychotics: population-based case-control study.

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Leonor Laredo
Emilio Vargas
Antonio Javier Blasco
Maria Dolores Aguilar
Alfonso Moreno
Antonio Portolés

키워드

요약

OBJECTIVE

To explore the association between use of antipsychotics and risk of cerebrovascular accident (CVA) in individuals with dementia aged 65 and older.

METHODS

Population-based case-control study.

METHODS

UK-based electronic primary care records in the General Practice Research Database (GPRD).

METHODS

Individuals with dementia aged 65 and older registered in the database between January 1, 1995, and June 22, 2007.

METHODS

Odds ratio (OR) of CVA in users versus nonusers of antipsychotics (typical or atypical) and in users of typical versus atypical antipsychotics. Multivariate analyses were performed using logistic regression models to adjust for potential confounders: demographic variables, comorbidity, and concomitant treatments.

RESULTS

After adjusting for confounding variables, the OR of CVA associated with use of only typical antipsychotics versus no antipsychotics in individuals with dementia aged 65 and older was 1.16 (95% confidence interval (CI)=1.07-1.27) and for use of only atypical antipsychotics versus no antipsychotics was 0.62 (95% CI=0.53-0.72). In the comparison of typical versus atypical antipsychotics, the OR was 1.83 (95% CI=1.57-2.14).

CONCLUSIONS

No reasons were found to question the cerebrovascular safety of atypical antipsychotics in older adults with dementia. The typical antipsychotics appear to be associated with a higher risk of CVA, although the risk disappears after use is discontinued.

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