This commonly prescribed drug for sickness could triple your risk of a stroke, study suggests

Researchers from Bordeaux University have found that anti-nausea drugs could increase your risk of experiencing an ischaemic stroke. According to the NHS, ischaemic strokes are the most common type of stroke. They happen when a blood clot blocks the flow of blood and oxygen to the brain.

Antidopaminergic antiemetics: an introduction

Antidopaminergic antiemetics (ADAs) are commonly prescribed by the NHS to treat patients who are feeling sick due to different conditions, such as migraines or sickness related to receiving chemotherapy or radiotherapy as a part of cancer treatment.

ADAs are antidopaminergic drugs, which means they function by blocking dopamine activity in the brain. Dopamine is associated with nausea and vomiting. The specific ADAs that were studied were domperidone, metopimazine and metoclopramide.

Antipsychotics are also antidopaminergic drugs and have also been linked with an increased risk of ischaemic stroke. It was not known whether other antidopaminergics carry the same risk, so the researchers decided to find out.

The study, published in the British Medical Journal, examined data from a French healthcare system database with over 25,000 people.

The team compared 2,612 patients who experienced a first ischaemic stroke between 2012 and 2016 to a healthy control group of 21,859 randomly selected people who also received an ADA in the same time period.

Among patients who had a stroke, 1,250 received an ADA at least once in the risk period and 1,060 in the reference periods. Among the control group, 5,128 and 13,165 received an ADA at least once in the risk and reference periods, respectively.

Increased risk of having a stroke

The study indicates that users might have a 2.5 and 3.5 times increased risk of an ischaemic stroke. The research also suggests that most of the strokes occurred within 14 days of taking the medication.

The higher risk could be attributed to the potential action of ADAs on blood flow to the brain. The lead author of the study, Anne Bénard-Laribière, a pharmacologist at Bordeaux University, said:

The higher risk found for drugs crossing the blood-brain barrier suggests a potential central effect, possibly through an action on cerebral blood flow.

Even after considering potentially influential factors, the researchers found that new users of ADAs could be at a 3-fold higher risk of stroke 14 days after beginning treatment.

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Sources used:

BMJ:Risk of first ischaemic stroke and use of antidopaminergic antiemetics: nationwide case-time-control study

NHS