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Associations between prescribed amphetamines and spontaneous cervical artery dissection: a matched case-control study
Dillan Prasad1, Amr Alwakeal1, Rishi Jain1
1Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611, USA.
Summary
Prescribed amphetamines are linked to a moderately increased risk of spontaneous cervical artery dissection (sCeAD), a key cause of stroke in younger individuals. This observational study suggests a potential association in certain patients.
Area of Science:
- Neurology
- Vascular Medicine
- Pharmacology
Background:
- Spontaneous cervical artery dissection (sCeAD) is a significant cause of stroke, particularly in young adults.
- Understanding potential risk factors for sCeAD is crucial for stroke prevention strategies.
Purpose of the Study:
- To investigate the association between prescribed amphetamine use and the occurrence of spontaneous cervical artery dissection (sCeAD).
Main Methods:
- A retrospective, matched case-control study was conducted involving adults aged 18-85.
- Cases with incident sCeAD were matched 1:4 to controls on age, sex, and race/ethnicity.
- Conditional logistic regression analyzed the association between amphetamine prescription and sCeAD, controlling for covariates.
Main Results:
- Amphetamine exposure was associated with increased odds of sCeAD (adjusted OR 1.70).
- High-dose amphetamine use (≥30 mg/day) showed the strongest association (OR 1.96).
- Results were consistent across sensitivity analyses, including inverse probability weighting.
Conclusions:
- Prescribed amphetamines are associated with a modest increase in the odds of sCeAD.
- These observational findings are hypothesis-generating and suggest a potential link in susceptible individuals.