Association between antipsychotics and cardiovascular adverse events: A systematic review

Abstract

Summary Objective: Determine whether there is an association between the risk of cardiovascular adverse events and the use of antipsychotic agents. Method: Analysis of original articles retrieved from the following databases: LILACS, PubMed, Cochrane Controlled Trials Clinical Data Bank (CENTRAL) and PsycINFO, without language restriction, dated until November 2015. After screening of 2,812 studies, three cohort original articles were selected for quality analysis. Results: 403,083 patients with schizophrenia and 119,015 participants in the control group data were analyzed. The occurrence of cardiovascular events observed in the articles was: 63.5% (article 1), 13.1% (article 2) and 24.95% (article 3) in the group of treated schizophrenic patients, and 46.2%, 86.9% and 24.9%, respectively, in the control groups. Conclusion: Clinical heterogeneity among the studies led to a provisional response and made it impossible to perform the meta-analysis, although the articles demonstrate an association between cardiovascular adverse events and the use of antipsychotics. More quality clinical trials are needed to support this evidence.

Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies

“…Atypical antipsychotic (AAP) use has been linked to an increased risk of metabolic syndrome, diabetes and cardiovascular disease (1–4). These conditions are, in part, due to the insulin resistance and weight gain caused by these medications (5, 6).…”

Doenças cardiovasculares e uso de antipsicóticos na esquizofrenia: uma revisão

“…Em consonância com outros estudos, as manifestações cardíacas associadas aos antipsicóticos apontam aumento do risco de eventos adversos como arritmia, IAM e mortalidade J Bras Psiquiatr. 2022 em pacientes esquizofrênicos 98 . Tem-se o prolongamento do intervalo QT como importante alteração decorrente do uso de antipsicótico, tanto atípico quanto típico.…”

Ascorbic acid supplementation attenuates schizophrenia‐like symptoms in an animal model induced by ketamine

“…Some studies point to the occurrence of anti‐inflammatory action in the use of ketamine, thus limiting the exacerbation of systemic inflammation (Loix, De Kock, & Henin, 2011; Taniguchi, Shibata, & Yamamoto, 2001; Yang et al., 2005). Moreover, studies pointing to the opposite, that ketamine may increase the levels of IL‐6 and IL‐1β inflammatory cytokines, which would lead to neuroinflammation (da Silva et al., 2017; Li et al., 2017). With these conflicting data, we emphasize the need for further studies with new SZ models to better analyze changes in cytokine levels and their influence on the development of the disorder.…”

“…Schizophrenia (SZ) is a complex and debilitating brain disorder affecting approximately 1% of the world population (Boison, Singer, Shen, Feldon, & Yee, 2012; Gogtay, Vyas, Testa, Wood, & Pantelis, 2011). SZ symptoms can be classified into positive symptoms (delusions, delirium, hallucinations, and disorganized thoughts), negative symptoms (social and emotional isolation, affective blunting and anhedonia) and cognitive disabilities (disorganization, disorientation and lack of attention) (Bowie & Harvey, 2006; Gogtay et al., 2011; Silva, Ribeiro, Sousa‐Rodrigues, & Barbosa, 2017).…”