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Increased cardiovascular risk with second-generation antipsychotic agent switches
L Douglas Ried1, Bernard T Renner, Joel R McConkey
1Pharmacy Health Care Administration, College of Pharmacy, P.O. Box 100496, University of Florida, Gainesville, FL 32610-0496, USA. ried@cop.ufl.edu
Journal of the American Pharmacists Association : Japha
|August 18, 2006
Summary
Switching antipsychotics can alter cardiovascular risk. Some medication switches may lower risk, while others, like risperidone to olanzapine, increase it by 33%.
Area of Science:
- Psychiatry and Pharmacology
- Cardiovascular Medicine
Background:
- Second-generation antipsychotics (SGAs) are used for schizophrenia and schizoaffective disorder.
- Cardiovascular events are a significant concern in patients using SGAs.
Purpose of the Study:
- To model the risk of adverse cardiovascular events when switching between different SGAs.
- To inform clinical decisions regarding SGA selection based on cardiovascular risk.
Main Methods:
- Literature search of PubMed (1985-2004) using terms related to SGAs, metabolic syndrome, and cardiovascular risk.
- Study selection and data extraction performed by the authors.
Main Results:
- The choice of SGA can influence cardiovascular event risk.
- Switching from olanzapine to risperidone may lower risk.
- Switching from risperidone to olanzapine or clozapine may increase risk by up to 33%.
Conclusions:
- Cardiovascular risk varies with SGA choice, but data on metabolic changes are limited.
- Prospective studies are needed to guide evidence-based strategies for optimal SGA selection.
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