Cardiovascular Toxicity as a Result of Psychotropic Drugs

Cardiovascular disease (CVD) is one of the leading causes of death in the general population. An overwhelming body of evidence suggests that patients with serious mental illness (SMI) are at significantly higher risk for cardiovascular morbidity and mortality than those in the general population. The etiology of this excess CVD is multifactorial and includes the excessive accumulation of risk factors such as smoking, obesity, physical inactivity, and dyslipidemia in SMI patients, but other mechanisms due to the mental illness itself, as well as the effects of psychotropic drugs, may also be influential in increasing risk in this group. Psychotropic medications are prescription drugs that are used to treat or manage psychiatric symptoms or challenging behaviors; these include antipsychotics, antidepressants, and anxiolytics, as well as mood stabilizers. Such drugs act both directly and indirectly on the cardiovascular system producing adverse effects that range from orthostatic hypotension to sudden cardiac death. This chapter focuses predominantly on the effects of the available antipsychotic and antidepressant medications reported to be used among clinical populations.