A study published by the BMJ shows that antidopaminergic antiemetics (ADAs) used to treat nausea and vomiting increases the risk of ischemic stroke. Conditions such as migraine, after surgery, chemotherapy and radiotherapy, causes nausea and vomiting.
Three ADAs used to treat nausea and vomiting, namely domperidone, metoclopramide, and metopimazine, were studied. They were all found to result to increase in ischemic stroke risks, 12 times higher in the especially in the first month of use, and decreasing with time. Metopimazine and metoclopramide resulted in the highest risks observed.
ADAs are antidopaminergic drugs that work on the brain blocking the dopamine activity, the same mechanism as antipsychotic drugs. Researchers suggest the actions of ADAs on the blood flow to the brain may explain the increase in stroke risks.
In the observational study, researchers at the French Iserum and Bordeaux University, and Bordeaux CHU, tried to associate ADA use to an increase in ischemic stroke in the real world setting. About 2,612 patients who had the first ischemic stroke attack between 2012 and 2016, and has received at least one reimbursement of ADA in 70 days before the stroke took part. The patients were above 18 years, with an average age of 72 years.
The time trend of the ADA use was controlled by a control group of randomly selected 21 859 people. These people are free from the event and were individually matched to patients with stroke according to age, sex, and risk factors of ischaemic stroke.
As this study is an observational study, it cannot establish a cause. Researchers also pointed to limitations in the database studies, such as poor information on the prescribed doses of ADAs used, the duration, and the subtypes of the ischemic stroke.
But the result proved that the use of ADAs can increase the risks of ischemic stroke.