Health

Nausea drugs linked to higher stroke risk


Like antipsychotics, ADAs are antipsychotics — they work by blocking the action of dopamine in the brain. Antipsychotics are associated with an increased risk of ischemic stroke, but whether this risk extends to other antipsychotics including ADA is unknown.

To address this gap, a team of researchers in France from the Universities of Inserm and Bordeaux (Bordeaux Population Health Center) and Bordeaux CHU, set out to estimate the risk of ischemic stroke related to the use of ADA in a real-world setting.

They identified 2,612 patients from the French nationwide reimbursement system (SNDS) database with their first ischemic stroke between 2012 and 2016 and at least one of them. reimburse domperidone, metopimazine, or metoclopramide for the 70 days before their stroke. Patients had a mean age of 72 years and 34% were male.

They compared the frequency of these ADA reimbursements between the risk period (days -14 to -1 before stroke) and three matched reference periods (days -70 to -57, -56 to -43 and -42 to -29 before stroke).

The stroke patients were then matched for age, sex, and stroke risk factors with a healthy control group of 21,859 randomly selected individuals who also received ADA during the same time period.

Among the stroke patients, 1,250 received ADA at least once during the risk period and 1,060 during the reference period. Among the control group, 5,128 and 13,165 received ADA at least once during the risk and reference periods, respectively.

After looking at likely influencing factors, the researchers found that people who were new to ADA could triple their risk of stroke soon after starting treatment.

Further analyzes by age, sex and history of dementia yielded similar results, with men having the highest risk (3.59-fold increase).

Risk appeared to be increased for all ADAs, with the highest increases found for metopimazine (3.62-fold increase) and metoclopramide (3.53-fold increase), both of which are blood-barrier drugs. Brain.

This was an observational study and, therefore, cause could not be determined, and the researchers point to some limitations inherent in database studies, such as a lack of information on daily dosing. indication or duration of ADA and ischemic stroke types.

And although further causal inference studies are needed to confirm this association in other settings, they suggest that “a higher risk was found when the drug crossed the blood-brain barrier showing an effect.” latent centres, possibly through effects on cerebral blood flow.”

Source: Eurekalert



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