Powerful antipsychotic could be banned after stroke risk revealed

A powerful antipsychotic for agitation and aggression increases the risk of stroke to such an extent that it could be too dangerous to prescribe.

Risperidone, marketed as Risperdal, is regularly given to dementia patients, especially in care homes, to calm them if they get agitated or aggressive—but researchers say that safer alternatives may need to be found.

Although everyone knew that risperidone increases the risk of stroke, researchers from Brunel University in London were shocked to discover just how much it raises the risk.  The risk of stroke was believed to be confined to patients who had already suffered a stroke, but the researchers found that it increased the risk in those who had been stroke-free or didn’t have a history of heart disease.

In a study involving more than 165,000 dementia patients, the researchers discovered that the drug raised the risk of a second stroke by around 22 percent, while the risk was just 17 percent in stroke victims not given the drug.

For those who hadn’t suffered a stroke before, the risk was 2.9 percent while on the drug, compared to 2.2 percent in the non-drug group, and the risk was apparent within 12 weeks of starting medication.

Guidelines recommend prescribing the drug for no more than six weeks, but many patients are on it for far longer.

The results may change clinical practice in treating aggression and agitation in dementia patients, the researchers say.

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