Shocking Results from a Recent UK Study
Abstract
A recent UK study has revealed alarming findings about the antipsychotic medication risperidone, commonly used for treating agitation in dementia patients. This analysis of 165,000 cases indicates that risperidone increases the stroke risk by at least 28%, regardless of prior heart conditions. The study challenges long-held assumptions and emphasizes that no patient group can be deemed safe from this risk. It calls for immediate reevaluation of dementia care guidelines, urging healthcare professionals to focus on patient safety and holistic care approaches. Caregivers are advised to regularly monitor patients and reassess risperidone usage as necessary.
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This is Dr. Khalid Rahman (A health scientist, scholarly communicator, and licensed practitioner of integrative medicine) – PhD Clinical Research, MSc Bioinformatics, MSc Clinical Research & Regulatory Affairs, P.G.D.C.A, Bachelor of Unani Medicine & Surgery). I was recently invited to the Digitalmehmet Content Ecosystem as a guest blogger offering my research as free to the community to be useful. My goal is to share credible content from my research in medical and health science literature.
Stroke danger in dementia
What if you got to know that risperidone in dementia is no longer a safe treatment for the elderly? From a clinician’s point of view or a caregiver’s perspective, it’s essential to know what this new study has brought to the forefront.
It’s only when the care burden of dementia increases over time, and when the healthcare of the elderly becomes increasingly challenging, that clinicians turn to risperidone, aiming to lower episodes of aggression or extreme agitation.
However, a landmark analysis in the UK has revealed a troubling finding. The study findings state that risperidone increases the risk of stroke in almost every patient with a dementia diagnosis.
This means it doesn’t matter whether an older patient with dementia had a heart problem in the past; if risperidone is in the prescription, a stroke can knock on the door anytime. This groundbreaking study has challenged the long-held assumptions about dementia therapy.
With these new findings in hand, caregivers, doctors, and families must not wait to initiate evidence-based conversations with honesty in the best interest of the patients being treated.
This is undoubtedly a wake-up call.
Researchers in this latest study analyzed 165,000 dementia cases by extracting 19 years of data from the National Health Service (NHS) and reached a unanimous, eye-opening conclusion.
The significant finding was that taking risperidone increased the risk of stroke at least by 28% in patients with dementia in comparison to those who were never prescribed risperidone therapy.
The study showed that this 28% stroke risk also existed in those patients who never had any past occurrences of stroke or any heart health-related condition. The lead author of this study stated that his team had suspected the stroke-causing potential of risperidone. They only wanted to understand in which specific group this drug can have more adverse reactions.
Now the results, published in the British Journal of Psychiatry, state that safety cannot be ascertained in any patient group.
The outcome has served as a wake-up call to the healthcare community, urging them to urgently revisit the dementia care guidelines. The following BioTuberOnline video podcast has unboxed the significant findings from this latest study and its implications for the healthcare system.
Many of us might have heard the name of this antipsychotic drug for the very first time. This is the only medicine approved to treat agitation or aggressive behaviors in dementia in the United Kingdom. As a standard procedure, physicians opt for this remedy only when all other non-drug approaches have failed to achieve the desired outcomes.
What is risperidone and why does it matter?
Research says that approximately 50% of those with dementia develop agitation, and this behavior adversely impacts their ongoing care as well as health-related quality of life.
Risperidone becomes the last resort only when other evidence-based approaches, such as patient-centered communication, cognitive behavioral therapy, routine adjustments, or music therapy, singly or in any combination, appear insufficient to help the patient.
The NHS guidelines state that risperidone should not be used beyond 6 consistent weeks and that close monitoring of the patient’s condition is highly needed to reduce the risk of side effects or adverse events.
But for one reason or another, several patients receive risperidone treatment for a much longer duration, and many times without regular monitoring.
Summary of Alarming Statistics
This study revealed that patients with dementia receiving risperidone had 53 stroke events per 1000 person-years. These events were significantly higher than 41 stroke events per 1000 person-years, observed in patients who never received risperidone treatment.
Additionally, the sensitivity analysis revealed that in a specific tenure, a 22% stroke rate occurred in patients with risperidone therapy. However, in matched controls who never received risperidone, a 17.7% stroke rate was reported within the same duration. Additionally, no significant difference in stroke rate was observed between risperidone users (2.9%) and non-users (2.2%) who had never had any event of stroke in the past.
To put these outcomes into perspective, the health risks with risperidone could not be eliminated with any specific baseline characteristic. Even a 12-week risperidone treatment was associated with occurrences of stroke events in patients with dementia.
Unboxing the biology of risperidone-related health adversities in dementia
This research has left us contemplating the real cause of these adversities and why they were not previously identified. How can such a drug with a questionable health profile get approval for dementia treatment?
Laboratory analysis has shown that risperidone not only interacts with the brain but also communicates with the cardiovascular biology. Now, what does this imply? It means that risperidone plays a role in altering the proteins and genes responsible for clot formation and the regulation of blood vessel function.
So, the findings from this study mean that patients who appear otherwise healthy may also have a susceptibility to stroke after risperidone therapy. The authors of this study emphasized that these biological revelations warrant further research and underscore the urgent need to explore safer options for improving and scaling up dementia care processes.
What do these findings mean in clinical practice?
The current state of dementia care with this new study can become increasingly complex, and the physicians might find it challenging to control intense episodes of agitation in the absence of an appropriate drug.
Research tells us that it’s challenging to quantify suffering due to agitation in dementia, which can lead to injuries and hospitalizations among patients. This study calls for the urgent need to evaluate the benefits and risks of dementia support measures, enabling more informed healthcare decisions and the optimal use of all available treatment approaches.
Since the real-world evidence shows the relative risk of stroke in all types of patients with dementia, regular patient monitoring is something doctors cannot ignore in dementia care. Of course, a thorough assessment of patients’ health profiles is the first step in improving treatment choices.
Practical Tips for Caregivers
If you are a caregiver for a patient with dementia, ensure compliance with the following recommendations, which align with standard dementia management guidelines.
- Seek health monitoring plans and treatment duration recommendations from your physician.
- In case a stroke event is reported for the patient with dementia, ensure to schedule 3-monthly routine check-ins.
- Assess any changes in walking patterns/balance, speech issues, or instant weakness in the patient.
- In case your patient has been on risperidone for over 6 weeks, immediately request a medication review from the treatment provider.
What is the safest option for dementia care?
Today, there is a problematic situation for dementia care since none other than risperidone is the approved treatment, and that too would probably face scrutiny based on the current study’s astonishing results.
Although atypical antipsychotics such as olanzapine or quetiapine are at times considered off-label use drugs, they have their own shortcomings, such as serious adverse events, not limited to stroke, and death.
Currently, physicians have risperidone as the last resort for agitation management in dementia. This is why it’s so important to analyze the health risks as early as possible with regular monitoring.
Optimizing scientific evidence with empathy
The statistics from this latest study have driven healthcare choices to extremes. This study provides insight into how even the slightest change in relative health risk can have profound life-changing consequences.
In fact, the foremost step in dementia care is to maintain health-related quality of life. Currently, the physicians may not be able to completely block the risperidone option in dementia care until they receive specific guidelines from the relevant health authorities.
However, what they can do is to recognize the early signs and aim to administer person-centered holistic care to reduce the risk of health complications. Empathy and compassion are essential prerequisites for improving the overall quality of dementia care interventions.
Conclusions and Key Takeaways for Everyone
The outcomes of this risperidone – dementia study are shocking and troublesome, with the revelation that there are possibly no safe patient groups. This is why physicians must practice extra caution while supporting the dementia-affected families.
It’s the duty of modern-day physicians to transparently share all possible healthcare options with patients and their families, and opt for the best evidence-based approaches that offer maximum health benefits with minimal or no health risks.
Future research is the way forward to enhance dementia care practices. More physicians and researchers should collaborate globally in the interest of humanity and conduct real-world prospective and retrospective studies to develop more robust treatment algorithms for dementia management.
Until then, personalized care and holistic support remain the most viable approaches to improve care outcomes.
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Cited References in This Article
Brunel University of London. (2025, October). Dementia drug raises stroke risk, even in ‘low-risk’ patients, study shows. Medical Xpress. Edited by Lock, L., reviewed by Egan, R.
Choma, J., Griffiths, A., Henley, W., Mueller, C., Williams, N., Ballard, C., Hopkins, R., Young, K. G., Dennis, J. M., & Creese, B. (2025, October 9). Risk of stroke associated with risperidone in dementia with and without comorbid cardiovascular disease: Population-based matched cohort study. The British Journal of Psychiatry.
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