Toggle Main Menu Toggle Search

Open Access padlockePrints

Cardiac side effects of psychiatric drugs

Lookup NU author(s): Dr Paul Mackin

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

This review describes the common effects of psychotropic drugs on the cardiovascular system and offers guidance for practical management. Selected reports from the literature describing common side effects associated with psychotropic drugs are reviewed, and suggestions for further reading are given throughout the text. Orthostatic hypotension is the most common adverse autonomic side effect of antipsychotic drugs. Among the atypical antipsychotics the risk of orthostatic hypotension is highest with clozapine and among the conventional drugs the risk is highest with low potency agents. Rarely, orthostatic hypotension may result in neurocardiogenic syncope. QTc prolongation can occur with all antipsychotics but an increased risk is seen with pimozide, thioridazine, sertindole and zotepine. QTc prolongation is a marker of arrhythmic risk. Torsade de pointe, a specific arrhythmia, may lead to syncope, dizziness or ventricular fibrillation and sudden death. Heart muscle disease presents most commonly in the elderly as chronic heart failure, but myocarditis and cardiomyopathy, although relatively rare, are devastating, but potentially reversible complications of psychotropic drug therapy have been particularly linked to clozapine treatment. Patients with severe mental illness (SMI) are a 'high risk' population with regard to cardiovascular morbidity and mortality. It is probable that many patients accumulate an excess of 'traditional' risk factors for the development of cardiovascular disease, but other mechanisms including psychotropic drugs may also be influential in increasing risk in this vulnerable group. These risks need to be seen in the context of the undoubted therapeutic efficacy of the psychotropic armamentarium and the relief that these drugs bring to those suffering from mental disorder. Copyright © 2007 John Wiley & Sons, Ltd.


Publication metadata

Author(s): Mackin P

Publication type: Review

Publication status: Published

Journal: Human Psychopharmacology

Year: 2008

Volume: 23

Issue: 1

Pages: 3-14

Print publication date: 01/01/2008

ISSN (print): 0885-6222

ISSN (electronic): 1099-1077

URL: http://dx.doi.org/10.1002/hup.915

DOI: 10.1002/hup.915

PubMed id: 18098218


Share