No CrossRef data available.
Rapid Review: Ascertaining the Type of Potentially Life-Threatening Cardiovascular Events and Eventual Cardiovascular Mortality From Antipsychotic Use in Clinical Practice
Published online by Cambridge University Press: 01 August 2024
Abstract
According to the World Health Organization (WHO), there has been a 13% increase in mental health and substance abuse disorders within the last decade. Typical and atypical antipsychotics are the most common treatment mechanisms for mental health-related disorders such as schizophrenia, depression with psychotic symptoms and bipolar disorders. However, antipsychotic usage is associated with more than a 50% increase in CVD such as ischaemic heart disease, resulting in cardiovascular-related mortality.
This review aims to investigate the most common type of cardiovascular event causing mortality due to antipsychotic use.
A systematic search within PubMed and Medline was conducted on 3 October 2023. Selection criteria were limited to English, full-text studies excluding case reports. The time frame selected was up to 3 October 2023. All studies included adults only. Interventions of focus include typical and atypical antipsychotics licensed in the UK. Outcome measures include cardiovascular mortality/events post-antipsychotic prescription.
13 studies were included out of 1088 records. Studies originated from 4 nations with the most studies coming from the USA (n = 7), UK (n = 2), Taiwan (n = 2) and Canada (n = 2).
The most common antipsychotic reported in the records was risperidone (n = 11), followed by haloperidol (n = 9), olanzapine (n = 8) and quetiapine (n = 8).
From data extraction, the most common cardiovascular events leading to death were sudden cardiac death/arrest (n = 6), ventricular arrhythmias (n = 6), myocardial infarction (n = 4), and heart failure (n = 2).
Due to data heterogeneity, discrete outcome measures were extracted from each record. This included outcomes measuring: relative risk between various groups (n = 9), rate of cardiovascular event per 100 patient year (n = 3), and mortality post cardiovascular event (n = 1).
From this study, ventricular arrhythmias and sudden cardiac deaths were the most common cardiovascular events secondary to antipsychotic use leading to mortality. Owing to patient safety and benefits, patients with psychotic illness are unable to go untreated. They are consequently very vulnerable to the cardiovascular side effects of prescribed high-dose antipsychotic drugs. Despite current monitoring guidelines worldwide, cardiovascular-associated mortality in patients on antipsychotics is still elevated. This may indicate the potential inadequacy of current measures for these patients while demonstrating the need for more aggressive cardioprotective interventions and monitoring.
- Type
- 1 Research
- Information
- BJPsych Open , Volume 10 , Supplement S1: Abstracts from the RCPsych International Congress 2024, 17–20 June , June 2024 , pp. S55
- Creative Commons
- This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Copyright
- Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists
Footnotes
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.
eLetters
No eLetters have been published for this article.