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    题名: Antipsychotic medications and stroke in schizophrenia: A case-crossover study
    作者: Chen, Wen-Yin
    Chen, Lian-Yu
    Liu, Hsing-Cheng
    Wu, Chi-Shin
    Yang, Shu-Yu
    Pan, Chun-Hung
    Tsai, Shang-Ying
    Chen, Chiao-Chicy
    Kuo, Chian-Jue
    贡献者: 心理系
    日期: 2017-06
    上传时间: 2017-07-27 12:44:06 (UTC+8)
    摘要: Background: The 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. Methods: Using 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 casecrossover 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. Results: Use 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). Conclusions: Use 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. © 2017 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    關聯: PLoS ONE, 12(6), e0179424
    数据类型: article
    DOI 連結: http://dx.doi.org/10.1371/journal.pone.0179424
    DOI: 10.1371/journal.pone.0179424
    显示于类别:[心理學系] 期刊論文

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