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Cerebro- and cardiovascular conditions in adults with schizophrenia treated with antipsychotic medications.

Jerrell JM, McIntyre RS

University of South Carolina School of Medicine, Columbia, SC 29203, USA. jjerrell@gw.mp.sc.edu

OBJECTIVE: To report on the relative risk of cerebro- and cardiovascular disorders associated with antipsychotic treatment among adults with schizophrenia. METHOD: 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. CONCLUSION: No significant association between antipsychotic usage and cerebro- or cardiovascular disorders was noted.

Published 8 August 2007 in Hum Psychopharmacol, 22(6): 361-4.
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