Cardiovascular Effects of Psychotropic Drugs

BACKGROUND: Cardiovascular disease is the leading cause of death in the general population and accounts for approximately 30% of all deaths; some of these are due to fatal arrhythmias, especially ventricular fibrillation. In a psychiatric population the prevalence of cardiovascular disease is higher than in the general population because of a different lifestyle and greater frequency of risks factors such as smoking, obesity, and increased stress. The increased prevalence of sudden death in this patient population has given rise to the question of drug-induced cardiovascular and arrhythmic effects. This article reviews the principal classes of psychotropic medications and their effects on the heart. METHODS: The review is based on Medline, Pubmed, Cochrane, and literature searches of publications from the period 1984 to 2005. CONCLUSION: It is important for practitioners to be familiar with the possible effects of psychotropic medications on the cardiovascular system, especially in the elderly and other patients with preexisting cardiac problems. Before starting treatment with a new psychotropic medication, a careful history and physical are mandatory, and baseline liver, lipid, and kidney profiles as well as chest radiographic and electrocardiographic findings should be noted.