Image of Anna-Maija Tolppanen, Ph.D.; Image credit: University of Eastern Finland
Anna-Maija Tolppanen, Ph.D.; Image credit: UEF

People with Alzheimer’s disease have a high risk of stroke shortly after starting a course of antipsychotic drugs, a new study finds. 

Clinicians should assess the effectiveness and safety of those drugs soon after they are initiated and limit them to the shortest possible duration, investigators from the University of Eastern Finland said.

Antipsychotics are commonly used to treat neuropsychiatric symptoms in Alzheimer’s disease despite their known association with cardiovascular events and mortality. But research into stroke risk is limited and inconsistent, study lead Anna-Maija Tolppanen, Ph.D., noted. 

To examine this link, she and her colleagues performed a registry-based cohort study of more than 70,000 patients who had not had a prior stroke. Each of the 20,000 antipsychotic users in the group was matched to a non-user by sex, age and time since Alzheimer’s diagnosis.

Participants who took antipsychotics had greater odds of experiencing a stroke within 60 days of initiating the drug than did non-users. The overall association between antipsychotic use and stroke risk was not significant, however. There also was no difference in stroke risk between two antipsychotics commonly used in this population — risperidone and quetiapine — they reported. 

The likelihood of stroke in 60 days suggests that even short-term use of antipsychotics “should be avoided if possible,” they concluded.

The study was published in JAMDA.