Kuopio, Finland—Because Alzheimer's disease (AD) patients tend to be more predisposed to seizures than older adults in general, the use of antiepileptic drugs (AEDs) is more frequent in that population.

That’s why results of a new study are so significant. A report in the Journal of the American Heart Association noted that AED use is associated with an increased risk of stroke among patients with AD.

Furthermore, according to University of Eastern Finland researchers, it doesn’t seem to matter whether the AEDs prescribed were older or newer.

The study team emphasized that the risk of stroke was especially elevated for the first 3 months of AED use, and that it remained elevated after several chronic disorders, socioeconomic status, and use of concomitant medications were accounted for.

Used in the study was the MEDALZ (Medication Use and Alzheimer’s Disease) database, which includes all 70,718 Finns who received a clinically verified AD diagnosis from 2005 to 2011. The 5,617 incident AED users were matched with a similar cohort not taking the drugs.

Results suggest that AED use was associated with an increased risk of stroke compared with nonuse (inverse probability of treatment weighting hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.07-1.74), with the greatest risk during the first 90 days (adjusted HR, 2.36; 95% CI, 1.25-4.47) of AED use.

The associations were with two types of strokes—ischemic (inverse probability of treatment weighting HR, 1.34; 95% CI, 1.00-1.79) and hemorrhagic (inverse probability of treatment weighting HR, 1.44; 95% CI, 0.86-2.43), the researchers reported.

The study also found that the stroke risk of users of older AEDs did not differ from that of the users of newer AEDs (adjusted HR, 1.04; 95% CI, 0.71-1.53).

Stating that up to 1% of the population needs chronic antiepileptic treatment to control epilepsy, the researchers pointed out that other indications for AED use include neuropathic pain and dementia-related behavioral symptoms in AD patients.

“AED use was related to an increased risk of stroke, regardless of AED type. Our results highlight caution in AED use in this vulnerable population,” the study authors advised, adding, “The pathological changes in Alzheimer disease may increase the susceptibility to the adverse events of AEDs, and careful clinical consideration is needed before prescribing them to a person with Alzheimer disease.”

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