Associations between prescribed amphetamines and spontaneous cervical artery dissection: a matched case-control study.

Dillan Prasad; Amr Alwakeal; Rishi Jain; James G Lyman; Nikhil Sriram; Benjamin E Weiss; Joshua M Tennyson; Nicholas M D'Ambrose; James M Mossner; Joshua M Rosenow; Christopher S Ahuja

doi:10.1016/j.jocn.2026.112201

PubMed · 42520490

Associations between prescribed amphetamines and spontaneous cervical artery dissection: a matched case-control study.

Dillan Prasad·Amr Alwakeal·Rishi Jain·James G Lyman·Nikhil Sriram·Benjamin E Weiss·Joshua M Tennyson·Nicholas M D'Ambrose·James M Mossner·Joshua M Rosenow·Christopher S Ahuja

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Abstract

AIMS: To assess whether prescribed amphetamines are associated with spontaneous cervical artery dissection (sCeAD), an important cause of stroke in young adults. METHODS: We conducted a retrospective matched case-control study within a large academic health system in Chicago, Illinois. Adults aged 18-85 years with incident sCeAD were matched 1:4 to controls without dissection on age, sex, and race/ethnicity. The primary exposure was documented amphetamine prescription. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) controlling for relevant vascular and clinical covariates. Sensitivity analyses included strict matched-strata and inverse probability-weighted models. RESULTS: Among 11,463 individuals, including 2,293 cases and 9,170 controls, amphetamine exposure was associated with higher odds of sCeAD (adjusted OR 1.70, 95% CI 1.18-2.46). Results were unchanged in strictly matched strata (OR 1.70, 95% CI 1.18-2.46) and remained directionally consistent after inverse probability weighting (OR 1.40, 95% CI 1.09-1.79). High-dose amphetamine exposure (≥30 mg/day) had the strongest association (OR 1.96, 95% CI 1.18-3.26), whereas low-dose exposure was not statistically significant. CONCLUSION: Prescribed amphetamines were associated with modestly increased odds of sCeAD. While these findings are observational and hypothesis-generating, they may support a possible association in susceptible patients.

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Humans Case-Control Studies Female Middle Aged Adult Male Retrospective Studies Aged Aged, 80 and over Amphetamines Young Adult Adolescent Vertebral Artery Dissection Central Nervous System Stimulants Case-control study Cerebrovascular risk Prescription amphetamines Spontaneous cervical artery dissection Journal Article

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Dillan Prasad, Amr Alwakeal, Rishi Jain, James G Lyman, Nikhil Sriram, Benjamin E Weiss, Joshua M Tennyson, Nicholas M D'Ambrose, James M Mossner, Joshua M Rosenow, Christopher S Ahuja. 2026-07-27. Associations between prescribed amphetamines and spontaneous cervical artery dissection: a matched case-control study.. https://doi.org/10.1016/j.jocn.2026.112201

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