Taking drugs to fight nausea and vomiting can increase the risk of ischemic stroke, according to a new study from Inserm. Increased risks from the first days of treatment.

Anti Dopaminergic Antiemetics are associated with an increased risk of developing a stroke . It was researchers from Inserm and the University of Bordeaux who highlighted this link. The results have been published in the specialist journal British Medical Journal .

Stroke: increased risk with antipsychotic drugs already known

“To date, no study has been published evaluating the risk of ischemic stroke associated with exposure to antidopaminergic antiemetics. These drugs are however used very commonly: in 2017 in France, more than 4 million people had at least one reimbursement for metopimazine, the most used of them ”, explain the Inserm researchers.about:blank

Metopimazine is an antiemetic which is used in the management of nausea and vomiting of various origins ( acute gastroenteritis , migraine, post-operative context or in the context of chemo- or radiotherapy). It is a molecule that has antidopaminergic properties, like antipsychotic drugs . Knowing that since the 2000s, scientists have shown that taking these treatments is associated with an increased risk of stroke , they have therefore wondered about the risks associated with taking these antidopaminergic antiemetic drugs.

Antiemetics: increased risk of stroke from the first days of treatment

The researchers analyzed the data of 2,612 adults hospitalized for a first ischemic stroke and who started treatment with antiemetics in the 70 days preceding its occurrence . “In these subjects, the analyzes found a higher consumption of antiemetics in the days preceding the stroke marked by a peak in treatment initiation over this period ”, they reveal. This suggests that there would be “an increased risk of ischemic stroke at the start of use of these drugs”. These results were compared with another group of randomly selected people who did not have a stroke.

An increase in risk “two to three times higher” which was found for the three antiemetics studied: domperidone, metoclopramide and metopimazine . All medications with these chemicals have the same risk of adverse effects .

“This first study provides a strong signal , relating to drugs widely used in the general population. For the time being, it seems very important that these results can be replicated in other studies, studies which could also provide indications on the frequency of this adverse effect, which we could not measure here given the approach methodology adopted. Having precise information on the subtypes of ischemic strokes and their location would also make it possible to explore the mechanisms involved ,” explained Anne Bénard-Laribière, one of the authors of the study.