People with migraine, or undergoing chemotherapy or radiotherapy, are likely to suffer from nausea and vomiting and are known to use antidopaminergic antiemetics (ADAs) drugs. According to the study, published by The BMJ, the potential action of ADAs on blood flow to the brain could explain the higher risk of stroke.
"The higher risk found for drugs crossing the blood-brain barrier suggests a potential central effect, possibly through an action on cerebral blood flow," the researchers said. A team of researchers in France from Inserm and Bordeaux University (Bordeaux Population Health Centre) and Bordeaux CHU studied three ADAs - domperidone, metopimazine, and metoclopramide. All three were associated with an increased risk, especially in the first days of use, but the highest increase was found for metopimazine and metoclopramide.
Like antipsychotics, ADAs are antidopaminergic drugs - they work by blocking dopamine activity in the brain. Antipsychotics have been associated with an increased risk of ischaemic stroke, but whether this risk could extend to other antidopaminergics including ADAs is not known. In the study, the team included 2,612 patients with a first ischaemic stroke between 2012 and 2016 and compared by age, sex, and stroke risk factors to a healthy control group of 21,859 randomly selected people who also received an ADA in the same time period.