All-cause mortality was higher in patients with stroke and in controls that were treated with benzodiazepines, antidepressants, and antipsychotics, compared to their untreated counterparts, a study published in BMJ Open has found. 

A team of Danish researchers aimed to evaluate all-cause mortality in regards to use of benzodiazepines, antidepressants, and antipsychotics in patients with stroke and their matched controls. They obtained national register data from healthcare services from the Danish National Patient Registry in Denmark. Data on psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics. 

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Patients included in the study had a diagnosis of stroke and either no drug use or preindex use of psychotropic drugs (n=49,968). They were compared with study controls (n=86,100) matched on age, gender, marital status, and community location. The study’s primary outcome measure was all-cause mortality.

The findings showed all-cause mortality was higher in patients with previous stroke vs. controls. Mortality risk was increased for those prescribed serotonergic antidepressants (hazard ratio [HR] 1.699; P<0.001 in patients vs. HR 1.908; P<0.001 in controls). The increased risk was also seen for those prescribed tricyclic antidepressants (HR1.365; P<0.001 and HR 1.733; P<0.001), benzodiazepines (HR 1.643; P<0.001 and HR 1.776; P<0.001), benzodiazepine-like drugs (HR 1.776; P<0.001 and HR 1.547; P<0.001), first-generation antipsychotics (HR 2.001; P<0.001 and HR 3.361; P<0.001) and second-generation antipsychotics (HR 1.645; P<0.001 and HR 2.555; P<0.001), compared with no drug use. 

In general, a statistically and significantly higher mortality hazard ratio was observed for most psychotropic drug classes in controls vs. patients with stroke. Dr. Poul Jennum, an author of the study, noted “care should be taken in the use and prescription of such drugs, and that they should be used in conjunction with adequate clinical controls.” 

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