Cardiovascular aspects of antipsychotics

Curr Opin Psychiatry. 2010 Nov;23(6):574-81. doi: 10.1097/YCO.0b013e32833f46c9.

Abstract

Purpose of review: Schizophrenia is associated with increased mortality and reduced life expectancy, with cardiovascular disease being the most frequent cause of death. Antipsychotics have detrimental effects on different risk factors for cardiovascular disease. This review will focus on the relationship between antipsychotic treatment and cardiovascular disease.

Recent findings: The increased overall mortality and mortality from cardiovascular disease in schizophrenia are now well documented. Patients with schizophrenia are at risk of receiving less optimal treatment for cardiovascular disease. Patients with schizophrenia are at high risk of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Some antipsychotics, in particular, clozapine and olanzapine, frequently cause weight gain, dyslipidemia and diabetes mellitus. Antipsychotics differ in their effects on body weight, lipids and glucose regulation. However, the long-term effects of these differences between individual antipsychotics on overall mortality and cardiovascular mortality are not well established.

Summary: More research is needed to better understand the relationship between schizophrenia, antipsychotic treatment and cardiovascular disease. More effective treatment strategies need to be developed to reduce the burden of cardiovascular disease in schizophrenia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Body Weight / drug effects
  • Cardiomyopathies / chemically induced
  • Cardiomyopathies / complications
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / mortality
  • Diabetes Mellitus / chemically induced
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / psychology
  • Middle Aged
  • Myocarditis / chemically induced
  • Myocarditis / complications
  • Risk Factors
  • Schizophrenia / complications
  • Schizophrenia / drug therapy
  • Schizophrenia / mortality

Substances

  • Antipsychotic Agents