Acute Blood Pressure Changes Associated With Antipsychotic Administration to Psychiatric Inpatients

Area of Science:

• Psychiatry
• Pharmacology
• Cardiovascular Medicine

Background:

• Antipsychotic medications are crucial for managing psychiatric disorders.
• Acute blood pressure (BP) changes following antipsychotic initiation require careful monitoring.

Purpose of the Study:

• To examine BP fluctuations within 72 hours of starting antipsychotic therapy in hospitalized psychiatric patients.
• To identify specific antipsychotics associated with significant acute BP alterations.

Main Methods:

• Retrospective chart review of 60 adult psychiatric inpatients.
• Collected vital signs at 9 time points within 3 days of initiating 6 different antipsychotics.
• Analyzed data using mixed-effects repeated measures ANOVA and logistic regression.

Main Results:

• Olanzapine and risperidone significantly increased systolic BP (P < .01 and P = .01, respectively).
• Clozapine significantly decreased systolic BP (P = .02) and was associated with hypotension.
• No significant associations found for other antipsychotics with systolic BP or any antipsychotics with diastolic BP.

Conclusions:

• Initiating olanzapine, risperidone, or clozapine can lead to significant acute BP changes.
• These findings underscore the importance of monitoring BP during early antipsychotic treatment.
• Further prospective studies are recommended to validate these observations.