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Objective: To evaluate stroke risk among users of typical antipsychotics compared to users of atypical antipsychotics in a non-elderly and non-demented US population.
Methods: New users of antipsychotics aged 18-64 years without dementia were identified via electronic health care data from 13 health plans participating in the Sentinel System from January 2001 to September 2015. The risk of hospitalized stroke events, identified via ICD-9-CM diagnostic criteria, was compared between typical and atypical antipsychotic users using 1:1 matching on propensity score. Adjusted hazard ratios (HRs) and 95% CIs during the entire follow-up period and during 1- to 15-day and 16- to 90-day risk windows were estimated. The risk associated with haloperidol use was estimated separately.
Results: A total of 45,495 typical antipsychotic users were matched 1:1 to atypical antipsychotic users. While unmatched HRs suggest an increased stroke risk among typical antipsychotic users compared to atypical antipsychotic users, no increased risk was observed after matching during the entire follow-up period (HR = 0.87; 95% CI, 0.54-1.41), the 1- to 15-day risk window (HR = 1.16; 95% CI, 0.41-3.32), or the 16- to 90-day risk window (HR = 0.52; 95% CI, 0.20-1.36). The adjusted HR for haloperidol was 1.31 (95% CI, 0.54-3.21).
Conclusion: These findings were not suggestive of an increased stroke risk in typical antipsychotic users compared to atypical antipsychotic users in a non-elderly and non-demented population.
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http://dx.doi.org/10.4088/JCP.18m12636 | DOI Listing |
Psychol Med
September 2025
https://ror.org/03cv38k47University of Groningen, University Medical Centre Groningen, Center for Clinical Neuroscience and Cognition, Groningen, The Netherlands.
Background: After remission of a first-episode psychosis (FEP), antipsychotic discontinuation is associated with an increased risk of relapse compared to maintenance treatment. We studied short and longer-term effects of discontinuation of D receptor (DR) antagonist and partial agonist antipsychotics on striatal dopamine DR availability in FEP patients.
Methods: Remitted FEP patients underwent two [C]raclopride PET scans to measure striatal DR availability: 1 week after antipsychotic discontinuation (n = 16 antagonist users, n = 6 partial agonist users) and after being medication free for 6-8 weeks (n = 8 antagonist users, n = 5 partial agonist users).
Ther Adv Psychopharmacol
August 2025
H. Lundbeck A/S, Valby, Denmark.
Background: Extrapyramidal symptoms (EPS) in association with the long-acting, injectable, atypical antipsychotic aripiprazole once monthly (AOM) have been observed in clinical trials, but information on EPS requiring treatment with anticholinergic drugs in clinical practice is limited.
Objectives: The objective of this European post-authorisation safety study (PASS) was to assess the risk of EPS-related events, as defined by dispensings of anticholinergic drugs, linked to the use of AOM in routine clinical practice.
Design: This European cohort study was based on healthcare databases from Germany (German Pharmacoepidemiological Research Database GePaRD), Italy (Caserta and Palermo healthcare claims databases), and Sweden (National health registers).
Psychol Med
August 2025
Department of Psychiatry, https://ror.org/03nteze27National Taiwan University Hospital, Taipei, Taiwan.
Background: In patients with remitted psychosis, the dosage of antipsychotics can be lowered without increased risk of relapse. Whether dose tapering can lead to improved cognition is unclear. We compared changes in cognitive performance between patients undergoing dose tapering and those receiving a fixed maintenance dose.
View Article and Find Full Text PDFJ Clin Psychopharmacol
August 2025
Department of Medical Pharmacology and Toxicology, Addictovigilance Center.
Purpose/background: For several years, an increase in the nonmedical use of nitrous oxide (N 2 O) has been observed in France, among adolescents and young adults, sometimes associated with severe adverse events.
Methods/procedures: Analysis of spontaneous reports (SRs) concerning neuropsychiatric adverse events in N 2 O users, received by the Montpellier addictovigilance centre between 2022 and June 2024, and discussion of the underlying pharmacological mechanisms.
Findings/results: Nineteen severe SRs were analysed, mainly in men (73.
Schizophr Bull
August 2025
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom.
Background And Hypothesis: Clozapine treatment carries a risk of blood dyscrasias (BD) and requires indefinite monitoring in many jurisdictions, a major factor in its under-utilization. Although previous studies suggest BD risk is highest early in treatment, BD events have also been reported after many years. This study compares early vs late (>6 months) suspected blood dyscrasias (SBD) and examines rechallenge outcomes as a marker for clozapine-related causation.
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