3.3.2 Cerebrovascular events such as stroke
The risk of cerebrovascular adverse events, such as stroke, may be raised as much as three-fold in elderly patients with dementia prescribed an antipsychotic; mortality rate is also raised.
Factors which increase risk
The risk of stroke is raised in people with:
- cardiovascular disorders such as hypertension, previous stroke, atrial fibrillation, and heart valve disorders
- hypercholesterolaemia and dyslipidaemia
- adverse lifestyle factors including cigarette smoking, excessive weight, excessive alcohol consumption, lack of exercise
Antipsychotics should be prescribed for behavioural control in elderly patients with great care and usually only if non-pharmacological treatments have failed.
Where possible, modifiable risk factors (smoking, body weight, alcohol consumption and immobility) should be addressed as should cardiovascular disorders that increase the risk of cerebrovascular events.
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