Cerebrovascular risks of 1st- vs 2nd-gen antipsychotic use

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Cerebrovascular risks of 1st- vs 2nd-gen antipsychotic use A large population-based retrospective cohort study conducted by researchers in the US shows that, in older patients, the cerebrovascular risks associated with second-generation antipsychotics are no greater than those associated with first-generation antipsychotics. Medical claims data were analysed from 11 160 adults aged ≥50 years using either first- (n = 5580) or secondgeneration (n = 5580) antipsychotics. There was no significant difference between first- and second-generation antipsychotic users with regard to the risk of cerebrovascular adverse events (hazard ratio 0.858; 95% CI 0.689, 1.446); however, there was a significant ‘duration of therapy’ effect. Long-term use of either first- or second-generation antipsychotics (30–90 days or > 90 days) was associated with significantly greater risk of cerebrovascular adverse events than short-term use (< 30 days). The researchers conclude that "health care professionals should systematically identify predisposed cerebrovascular risk factors when planning to treat patients for a longer period of time." Mehta S, et al. Risk of cerebrovascular adverse events in older adults using antipsychotic agents: a propensity-matched retrospective cohort study. Journal of Clinical Psychiatry 71: 689-698, No. 6, 1 Jun 2010. Available from: URL: http:// 803032998 dx.doi.org/10.4088/jcp.09m05817yel

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Reactions 21 Aug 2010 No. 1315