Cerebro- and cardiovascular conditions in adults with schizophrenia treated with antipsychotic medications.
OBJECTIVE
To report on the relative risk of cerebro- and cardiovascular disorders associated with antipsychotic treatment among adults with schizophrenia.


METHODS
Medical and pharmacy claims data from the South Carolina Medicaid program were extracted to compare the prevalence rates for four coded cerebrovascular (cerebrovascular disease; cerebrovascular accident; cerebrovascular hemorrhage; and peripheral vascular disease) and four cardiovascular (myocardial infarction; ischemic heart disease; arrhythmias; and cardiomyopathy) conditions. The analysis employed a retrospective cohort design with a 3 years time period as the interval of interest. Schizophrenic adults (18-54) (n = 2251) prescribed one of six atypical or two conventional antipsychotic medications were identified and comprised the analysis set.


RESULTS
Incidence rates for cerebrovascular disorders ranged from 0.5 to 3.6%. No significant association between antipsychotic usage and cerebrovascular disorders was noted largely due to the low base rate. Incidence rates for overall cardiovascular conditions ranged from 6 to 20%. The odds of developing cardiomyopathy were significantly lower for aripiprazole (OR = -3.45; p = 0.02), while the odds of developing hypertension were significantly lower for males (OR = -1.37; p = 0.009) but significantly higher for patients prescribed ziprasidone (OR = 1.91; p = 0.01) relative to conventional antipsychotics.


CONCLUSIONS
No significant association between antipsychotic usage and cerebro- or cardiovascular disorders was noted.
Jerrell
Jeanette M
JM
University of South Carolina School of Medicine, Columbia, SC 29203, USA. jjerrell@gw.mp.sc.edu
McIntyre
Roger S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002561:Cerebrovascular Disorders / Q000139:chemically induced*; D015331:Cohort Studies; D016208:Databases, Factual; D050171:Dyslipidemias / Q000139:chemically induced; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents