Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan.
The University of Texas MD Anderson Cancer Center, Houston, TX.
J Am Med Dir Assoc. 2017 Aug 1;18(8):692-699. doi: 10.1016/j.jamda.2017.02.020. Epub 2017 Apr 18.
Studies investigating the association between antipsychotic use and the risk of cerebrovascular accident (CVA) showed inconsistent results.
Conduct a systematic review and meta-analysis to evaluate whether use of antipsychotics is associated with increased risk of CVA.
Major electronic databases were searched from 1970 to October 2016 for observational studies investigating the risk of CVA among users of antipsychotics. Pooled estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by random effects meta-analysis.
Of 1171 citations identified, 10 studies were considered eligible. Significant increase in risk of CVA was associated with first-generation antipsychotics (OR 1.49; 95% CI 1.24-1.77) but not with second-generation antipsychotics (OR 1.31; 95% CI 0.74-2.30). Use of any antipsychotics in patients with dementia was associated with a low risk of CVA (OR 1.17; 95% CI 1.08-1.26).
The available evidence suggests use of with first-generation antipsychotics as opposed to second-generation antipsychotics significantly increased the risk of CVA.
研究抗精神病药物使用与脑血管意外（CVA）风险之间的关系得出的结果并不一致。
进行系统评价和荟萃分析，以评估抗精神病药物的使用是否与 CVA 风险增加相关。
从 1970 年到 2016 年 10 月，主要电子数据库检索了观察性研究，以评估抗精神病药物使用者发生 CVA 的风险。通过随机效应荟萃分析获得优势比（OR）和 95％置信区间（CI）的汇总估计值。
在 1171 篇引用文献中，有 10 项研究被认为符合条件。第一代抗精神病药物与 CVA 风险增加显著相关（OR 1.49；95％CI 1.24-1.77），但第二代抗精神病药物则不然（OR 1.31；95％CI 0.74-2.30）。在痴呆患者中使用任何抗精神病药物与 CVA 风险降低相关（OR 1.17；95％CI 1.08-1.26）。
现有证据表明，第一代抗精神病药物的使用与第二代抗精神病药物相比，显著增加了 CVA 的风险。
