Br J Psychiatry

Risperidone linked to higher stroke risk in dementia patients, regardless of heart history

December 2, 2025

A UK cohort study of >164,000 older adults with dementia found risperidone was associated with a 28% increased risk of stroke compared with matched controls. Hazard ratios were similar for patients with and without CV disease or prior stroke. Incidence was highest among those with previous stroke (222 per 1,000 person-years) and CV disease (94 per 1,000 person-years).

Clinical takeaway: Discuss stroke risk before prescribing risperidone and limit use to the shortest duration possible, per guidelines.

Source:

Choma J, et al. (2025, October 9). Br J Psychiatry. Risk of stroke associated with risperidone in dementia with and without comorbid cardiovascular disease: population-based matched cohort study. https://pubmed.ncbi.nlm.nih.gov/41063545/