CoChat
Sign Up
Cited by 402Schizophrenia research and treatmentDementia and Cognitive Impairment ResearchPharmaceutical Practices and Patient Outcomes

Atypical antipsychotic drugs and risk of ischaemic stroke: population based retrospective cohort study

Open access
Gill, Sudeep S, Rochon, Paula A, Herrmann, Nathan, Lee, Philip E, Sykora, Kathy, Gunraj, Nadia, Normand, Sharon-Lise T, Gurwitz, Jerry H +3 more·2005·BMJ
DOI 10.1136/bmj.38330.470486.8fPMC PMC549652
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE: To compare the incidence of admissions to hospital for stroke among older adults with dementia receiving atypical or typical antipsychotics. DESIGN: Population based retrospective cohort study. SETTING: Ontario, Canada. Patients 32,710 older adults (< or = 65 years) with dementia (17,845 dispensed an atypical antipsychotic and 14,865 dispensed a typical antipsychotic). MAIN OUTCOME MEASURES: Admission to hospital with the most responsible diagnosis (single most important condition responsible for the patient's admission) of ischaemic stroke. Observation of patients until they were either admitted to hospital with ischaemic stroke, stopped taking antipsychotics, died, or the study ended. RESULTS: After adjustment for potential confounders, participants receiving atypical antipsychotics showed no significant increase in risk of ischaemic stroke compared with those receiving typical antipsychotics (adjusted hazard ratio 1.01, 95% confidence interval 0.81 to 1.26). This finding was consistent in a series of subgroup analyses, including ones of individual atypical antipsychotic drugs (risperidone, olanzapine, and quetiapine) and selected subpopulations of the main cohorts. CONCLUSION: Older adults with dementia who take atypical antipsychotics have a similar risk of ischaemic stroke to those taking typical antipsychotics.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmj.38330.470486.8f

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In older adults, psychotropic use has been associated with risk of severe adverse effects such as falls, stroke and mortality.

    “In older adults, psychotropic use has been associated with the risk of severe adverse effects such as falls [13–18], stroke [17, 19–22] and mortality [13, 23–25].”

    From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [20]

    The Introduction and Additional information sections report concerns and clinical-trial evidence suggesting an association between atypical antipsychotics and stroke in older adults with behavioural and psychological symptoms of dementia. That supports the stroke portion of the citing sentence, but not its broader reference to psychotropic use in older adults generally. The paper's own Results compare atypical with typical antipsychotics and find no significant difference in stroke risk. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. Lee PE, Gill SS, Freedman M, Bronskill SE, Hillmer MP, Rochon PA. Atypical antipsy- chotic therapy in the treatment of behavioural and psychological symptoms of demen- tia: systematic review. BMJ 2004;329:75-8.
  2. Brown TM, Boyle MF. Delirium. BMJ 2002;325:644-7.
  3. The CALM-AD trial-a randomised clinical trial of a cholinesterase inhibitor and atypical antipsychotic in the management of agitation in dementia. www.ihs.ox.ac.uk/ csm/rep%20RCT.html[_Toc21853935 (accessed 15 Nov 2004). (Accepted 1 December 2004) doi 10.1136/bmj.38330.470486.8F Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, ON, Canada · DOI
  4. Sharon-Lise T Normand professor of biostatistics Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA Jerry H Gurwitz professor Correspondence to: S S Gill, Room 1-152, Chapel Wing, St Mary's of the Lake Hospital, 340 Union Street, Kingston, ON, Canada K7L 5A2 gills@pccchealth.org Papers page 6 of 6 BMJ Online First bmj.com on 14 July 2023 by guest. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj.38330.470486.8F on 24 January 2005. Downloaded from · DOI

Cited by

Sorted by citations

Related

Authors
Gill, S. S., Rochon, P. A., Herrmann, N., Lee, P. E., Sykora, K., Gunraj, N., Normand, S.-L. T., Gurwitz, J. H., Marras, C., Wodchis, W. P., & Mamdani, M.
Affiliations
  • Institute for Clinical Evaluative Sciences (CA)
  • Baycrest Centre for Geriatric Care (CA)
  • Sunnybrook Health Science Centre (CA)
  • University of British Columbia (CA)
  • Harvard University (US)
  • University of Massachusetts Chan Medical School (US)
  • Toronto Western Hospital (CA)
  • Toronto Rehabilitation Institute (CA)
Corresponding author
Gill, Sudeep S
ORCID
Venue
BMJ
Publisher
BMJ
Published
2005-01-24
Volume
330
Issue
7489
Pages
445
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.38330.470486.8f
PMC
PMC549652
OpenAlex
W2099827319
Cited by
402
References
31
Citations by year
2026: 23 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 15 · 2021: 5 · 2020: 30 · 2019: 9 · 2018: 9 · 2017: 7 · 2016: 39 · 2015: 18 · 2014: 15 · 2013: 10 · 2012: 14
FWCI
28.07
Type
journal article
Language
en
Open access
Licence
www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Eli Lilly and Company
  • Pfizer
  • Heart and Stroke Foundation of Canada
  • Canadian Diabetes Association
  • Kidney Foundation of Canada
  • Eli Lilly Canada
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
atypical antipsychotics, typical antipsychotics, ischemic stroke, dementia, older adults, risperidone, olanzapine, quetiapine, stroke risk, hospitalization
MeSH terms
Aged, Dementia, Hospitalization, Humans, Ontario, Retrospective Studies, Risk Factors, Antipsychotic Agents, Cohort Studies, Incidence, Stroke

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review