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Managing cardiovascular disease risk in patients treated with antipsychotics: a multidisciplinary approach

Authors Shulman M, Miller A, Misher J, Tentler A

Received 17 May 2014

Accepted for publication 8 July 2014

Published 31 October 2014 Volume 2014:7 Pages 489—501

DOI https://doi.org/10.2147/JMDH.S49817

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Matisyahu Shulman,1 Avraham Miller,2 Jason Misher,3 Aleksey Tentler4

1Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA; 2The Ruth and Bruce Rappaport Faculty of Medicine, The Technion Israel Institute of Technology, Haifa, Israel; 3Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; 4Department of Internal Medicine, Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA

Background: The use of antipsychotic medication in the United States and throughout the world has greatly increased over the last fifteen years. These drugs have significant side effect burdens, many of them relating to cardiovascular health.
Objective: To review the available evidence on the major cardiovascular issues that arise in patients taking antipsychotic medication.
Method: A PubMed literature review was performed to identify recent meta-analyses, review articles, and large studies. Further articles were identified through cited papers and based on expert consultation when necessary.
Results: Clinical guidance on the following adverse effects and antipsychotics was reviewed: electrocardiogram (ECG) changes, (specifically, prolonged QT and risk of torsades de pointes), weight gain, dyslipidemia, metabolic syndrome, and myocarditis. Specific attention was paid to monitoring guidelines and treatment options in the event of adverse events, including dose change, medication switch, or adjuvant therapy.

Keywords: schizophrenia, prolonged QT, increased mortality, weight gain, myocarditis

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