Cardiometabolic Risk of Antipsychotics in Psychiatric Children Adolescents and Young Adults: A Multinational Self-Controlled Case Series

  • 張 育銓

Student thesis: Master's Thesis

Abstract

The study aimed to compare the risk of cardiometabolic events among antipsychotics in psychiatric children adolescents and young adult patients We included databases from Taiwan Hong Kong and the UK We conducted distributed network approach with common data model for the international study We performed self-controlled case series design and included population aged 6 to 30 years receiving antipsychotics with cardiometabolic events including stroke ischemic heart disease (IHD) acute myocardial infarction (AMI) hypertension type 2 diabetes mellitus (T2DM) and dyslipidemia We defined three risk periods based on the exposure of antipsychotics 1-30 days 30-90 days and 90+ days compared to the non-exposure period and performed conditional Poisson regressions to evaluate cardiometabolic risk We included a total of 107 425 19 034 7770 patients and of which 9730 233 120 patients had events from Taiwan Hong Kong and the UK respectively We found antipsychotics were associated with cardiometabolic risk in the window of 1-30 days (incident rate ratio [IRR] 1 56; 95% CI 1 45-1 68) and 90+ days (IRR 1 42; 1 32-1 53) in Taiwan Specifically we found haloperidol had higher risk of stroke (IRR 10 09; 8 24-12 35) and IHD (IRR 2 68; 1 96-3 66) in the window of 1-30 days and higher risk of hypertension (IRR 1 58; 1 19-2 11) and T2DM (IRR 1 85; 1 21-2 81) in the window of 90+ days in Taiwan Consistent findings from Hong Kong that haloperidol had higher risk of stroke (IRR 35 29; 4 63-269 25) and hypertension (IRR 2 19; 1 01-4 74) in the window of 1-30 days although we did not find consistent results from the UK We found risperidone had higher risk of stroke (IRR 1 96; 1 26-3 05) in the window of 1-30 days and higher risk of hypertension (IRR 1 53; 1 11-2 10) and dyslipidemia (IRR 2 12; 1 54-2 91) in the window of 90+ days in Taiwan The findings warrant attentions on varied cardiometabolic effects of haloperidol and risperidone suggesting we should use the antipsychotics with cautions to avoid unintended outcomes
Date of Award2018 Aug 17
Original languageEnglish
SupervisorEdward Lai (Supervisor)

Cite this

Cardiometabolic Risk of Antipsychotics in Psychiatric Children Adolescents and Young Adults: A Multinational Self-Controlled Case Series
育銓, 張. (Author). 2018 Aug 17

Student thesis: Master's Thesis