Calcium Channel Blockers

Calcium channel blockers were associated with significantly reduced stroke recurrence in non-AF patients. The study found no evidence that BP-CCB use was associated with lower or higher risk of any of the four neuropsychiatric outcomes compared with NP-CCB use. The study's support for CCBs in stroke recurrence partly aligns with guideline recommendations. The dose of a CCB required to achieve brain exposure sufficient to affect psychiatric outcomes may be higher than doses used in routine cardiovascular care. Prior clinical investigations of CCBs for schizophrenia and bipolar disorder produced no consistent or robust benefit and were constrained by small samples, short duration, and cardiovascular dose limits. Calcium channel blockers did not reach statistical significance for stroke recurrence reduction in AF patients. Currently approved CCBs generally cannot be administered at neuropsychiatrically relevant doses because of likely cardiovascular adverse effects. Brain-penetrant CCBs include felodipine, isradipine, nifedipine, and nitrendipine, while non-brain-penetrant CCBs include amlodipine, lacidipine, and levamlodipine. CCBs in this study were primarily prescribed for hyperte…