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[Psychopharmacotherapy in patients with cardiovascular diseases]
J Cordes1, C Lange-Asschenfeldt, C Hiemke
1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Deutschland. joachim.cordes@lvr.de
Insights
Patients with severe mental disorders face higher risks of cardiometabolic issues and mortality. Careful monitoring and interdisciplinary care are crucial for managing cardiovascular risks during psychopharmacological treatment.
Area of Science:
- Psychiatry and Cardiology
- Pharmacology and Toxicology
Context:
- Severe mental disorders are linked to increased cardiometabolic morbidity and mortality.
- Cardiometabolic safety is a critical concern in psychiatric treatment, especially with co-occurring conditions.
Purpose:
- To highlight the importance of cardiometabolic safety in psychiatric patients.
- To outline common adverse effects and management strategies for psychopharmacological treatments.
Summary:
- Psychiatric medications can cause side effects like lipid/glucose metabolism disturbances, weight changes, and QTc interval alterations.
- Individual vulnerability and specific drug properties influence the frequency and type of adverse events.
- Regular monitoring, including ECG, and prior cardiological assessment are recommended.
Impact:
- Emphasizes the need for interdisciplinary collaboration between cardiologists, general practitioners, and psychiatrists.
- Informs clinical practice regarding the comprehensive management of cardiovascular risks in patients undergoing psychiatric treatment.
Abstract:
Increased cardiometabolic morbidity and increased overall mortality has been observed in patients with severe mental disorders. Therefore, cardiometabolic safety is an important issue in the treatment of patients with psychiatric disorders, in particular in patients with comorbid cardiometabolic diseases. Frequent adverse side effects include disturbances of lipid and glucose metabolism, body weight changes and alterations of the QTc interval. Dependent on the particular substance used and on factors concerning individual vulnerability, these side effects vary in relative frequency. Therefore, regular monitoring is recommended including ECG. Furthermore, interactions between different medicaments may occur, either leading to enhanced or decreased drug concentrations. Prior to psychopharmacological treatment, proper cardiological treatment is recommended. The management of cardiovascular risks under psychopharmacology requires interdisciplinary cooperation between the cardiologist, general practitioner and psychiatrist.
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