Timing of stroke in elderly people exposed to typical and atypical antipsychotics: a replication cohort study after the paper of Kleijer, et al.

The paper is a post-hoc, dedicated re-analysis of the data taken from the Health Search Database selected for a previously published retrospective cohort study (Sacchetti, et al., 2008) on the incidence of firstever stroke in elderly primary care people, exposed or not to antipsychotic medication in monotherapy. Monthly time stratifications were made in order to investigate a possible time pattern. After life table analysis, the cumulative proportion surviving (free from stroke) at the end of the first month was 0.9921 (95% CI 0.9899–0.9943) in subjects exposed to antipsychotics and 0.9995 (95% CI 0.9993–0.9997) in unexposed subjects. During the third month, the proportions were 0.9898 (95% CI 0.9872–0.9924) in patients exposed to antipsychotics and 0.9981 (95% CI 0.9979–0.9983) in unexposed subjects, whereas at the sixth month, the figures were 0.9819 (95% CI 0.9761–0.9879) in exposed patients and 0.9964 (95% CI 0.9960–0.9968) in unexposed subjects. Therefore, our study supports the conclusion that, when compared with their nonexposed counterparts, elderly individuals newly exposed to antipsychotics in monotherapy have a risk for stroke that is overtly increased at the beginning of the treatment and thereafter returns progressively to normal or almost normal levels.