Antipsychotics and the Risk of Cerebrovascular Accident: A Systematic Review and Meta-Analysis of Observational Studies

Wan-Ting Hsu, Amin Esmaily-Fard, Chih-Cheng Lai, Darshan Zala, Sie-Huei Lee, Shy-Shin Chang, Chien-Chang Lee
2017 Journal of the American Medical Directors Association  
conventional antipsychotics atypical antipsychotics cerebrovascular accident ischemic stroke transient ischemic attack hemorrhagic stroke stroke dementia a b s t r a c t Background: Studies investigating the association between antipsychotic use and the risk of cerebrovascular accident (CVA) showed inconsistent results. Aim: Conduct a systematic review and meta-analysis to evaluate whether use of antipsychotics is associated with increased risk of CVA. Methods: Major electronic databases were
more » ... ic databases were searched from 1970 to October 2016 for observational studies investigating the risk of CVA among users of antipsychotics. Pooled estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by random effects meta-analysis. Results: Of 1171 citations identified, 10 studies were considered eligible. Significant increase in risk of CVA was associated with first-generation antipsychotics (OR 1.49; 95% CI 1.24e1.77) but not with secondgeneration antipsychotics (OR 1.31; 95% CI 0.74e2.30). Use of any antipsychotics in patients with dementia was associated with a low risk of CVA (OR 1.17; 95% CI 1.08e1.26). Conclusions: The available evidence suggests use of with first-generation antipsychotics as opposed to second-generation antipsychotics significantly increased the risk of CVA.
doi:10.1016/j.jamda.2017.02.020 pmid:28431909 fatcat:j5mle3pggfe6thkornvv7wozlq