ArticlePloS one2017
Antipsychotic medications and stroke in schizophrenia: A case-crossover study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers.
What it found
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Who cites it
14 citing papers in PubMed, 28 citations in OpenAlex.
- Impact of Schizophrenia on Inpatient Outcomes for Acute Ischemic Stroke: Evidence From the 2005-2020 United States Nationwide Inpatient Sample.Journal of clinical neurology (Seoul, Korea) · 2026Article
- Risk of Stroke in Patients With Schizophrenia, Bipolar Disorder, and Major Depressive Disorder: A Cohort Study of 183,504 Subjects.Acta psychiatrica Scandinavica · 2026Article
- Methadone-Induced Toxicity-An Unexpected Challenge for the Brain and Heart in ICU Settings: Case Report and Review of the Literature.Life (Basel, Switzerland) · 2025Article
- Article
- Leveraging Real-World Data in Safety Signal Assessment.Therapeutic innovation & regulatory science · 2024Article
- Incidence and Risk Profiles for Suicide Mortality in Patients With Schizophrenia Receiving Homecare Case Management in Taiwan.Schizophrenia bulletin · 2024Article
- Schizophrenia and Types of Stroke: A Mendelian Randomization Study.Journal of the American Heart Association · 2024Article
- Individual trigger factors for hemorrhagic stroke: Evidence from case-crossover and self-controlled case series studies.European stroke journal · 2023Review
- The impact of mental health conditions on oral anticoagulation therapy and outcomes in patients with atrial fibrillation: A systematic review and meta-analysis.American journal of preventive cardiology · 2021Article
- Stroke care and case fatality in people with and without schizophrenia: a retrospective cohort study.BMJ open · 2021Article
- Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke.Neuropsychiatric disease and treatment · 2019Article
- Correction: Antipsychotic medications and stroke in schizophrenia: A case-crossover study.PloS one · 2019Article
- Risk of ischemic stroke after discharge from inpatient surgery: Does the type of surgery matter?PloS one · 2018Article
- The Association of Pre-stroke Psychosis and Post-stroke Levels of Health, Resource Utilization, and Care Process: A Register-Based Study.Frontiers in neurology · 2018Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between antipsychotic use and the risk of stroke in schizophrenic patients is controversial. We sought to study the association in a nationwide cohort with schizophrenia.
methodsUsing a retrospective cohort of patients with schizophrenia (N = 31,976) derived from the Taiwan National Health Insurance Research Database, 802 new-onset cases of stroke were identified within 10 years of follow-up (from 2000 through 2010). We designed a case-crossover study using 14-day windows to explore the risk factors of stroke and the association between antipsychotic drugs and the risk of stroke. We analyzed the risks of individual antipsychotics on various subgroups of stroke including ischemic, hemorrhagic, and other strokes, and the risks based on the antipsychotic receptor-binding profile of each drug.
resultsUse of any second-generation antipsychotic was associated with an increased risk of stroke (adjusted risk ratio = 1.45, P = .009) within 14 days while the use of any first-generation antipsychotic was not. Intriguingly, the use of any second-generation antipsychotic was associated with ischemic stroke but not hemorrhagic stroke. The antipsychotic receptor-binding profile analysis showed that the antihistamine 1 receptor was significantly associated with ischemic stroke (adjusted risk ratio = 1.72, P = .037), and the sensitivity analysis based on the 7-day window of exposure validated the association (adjusted risk ratio = 1.87, P = .015).
conclusionsUse of second-generation antipsychotic drugs appeared to be associated with an increased risk of ischemic stroke in the patients studied, possibly mediated by high affinity for histamine-1 receptor blockade. Further research regarding the underlying biological mechanism and drug safety is suggested.
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