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Meta-analysis of population-based studies comparing risk of cerebrovascular accident associated with first- and second-generation antipsychotic prescribing in dementia

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Title: Meta-analysis of population-based studies comparing risk of cerebrovascular accident associated with first- and second-generation antipsychotic prescribing in dementia
Authors: Rao, A
Suliman, A
Story, G
Vuik, S
Aylin, P
Darzi, A
Item Type: Journal Article
Abstract: BACKGROUND: Second-generation antipsychotics (SGAs) are often prescribed in the treatment of Behavioral and Psychological Symptoms of Dementia (BPSD), however, their use has been discouraged in light of clinical trials suggesting that they cause an increased risk of cerebrovascular accidents (CVAs). OBJECTIVE: Aim of the study was to assess relative risk of CVA in dementia patients prescribed SGA rather than first-generation antipsychotics (FGAs), through meta-analysis of population-based studies. METHODS: A literature search was conducted using several relevant databases. Five studies were included in the review and data were pooled to conduct meta-analysis using the inverse variance method. RESULTS: A total of 79,910 patients were treated with SGAs and 1287 cases of CVA were reported. Of 48,135 patients treated with FGAs, a total of 511 cases of CVA were reported. The relative risk of CVA was 1.02 (95% CI 0.56-1.84) for the SGA group. There was no significant difference in the risk of stroke (p = 0.96) between groups, but significant heterogeneity was found among the results of included studies (p < 0.001). CONCLUSION: Meta-analysis of population-based data suggested that the use of SGAs as opposed to FGAs to control BPSD is not associated with significantly increased risk of CVA. Copyright © 2016 John Wiley & Sons, Ltd.
Issue Date: 27-Apr-2016
Date of Acceptance: 5-Feb-2016
URI: http://hdl.handle.net/10044/1/38747
DOI: https://dx.doi.org/10.1002/mpr.1509
ISSN: 1557-0657
Publisher: Wiley
Start Page: 289
End Page: 298
Journal / Book Title: International Journal of Methods in Psychiatric Research
Volume: 25
Issue: 4
Copyright Statement: © 2016 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Rao, A., Suliman, A., Story, G., Vuik, S., Aylin, P., and Darzi, A. (2016) Meta-analysis of population-based studies comparing risk of cerebrovascular accident associated with first- and second-generation antipsychotic prescribing in dementia. Int. J. Methods Psychiatr. Res., which has been published in final form at https://dx.doi.org/10.1002/mpr.1509. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Keywords: antipsychotics
dementia
epidemiology
Psychiatry
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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