Cardiovascular Changes due to Antipsychotic Agents among First Episode Patients with Schizophrenia

Antipsychotic medications increase cardiovascular diseases beyond schizophrenia. This effect is worsened by the kind of antipsychotics used.

To determine the cardiovascular changes due to antipsychotics in schizophrenic patients in tertiary hospitals in Enugu State, Nigeria.

This was a prospective analytical study of 64 schizophrenic in-patients screened using Mini International Neuropsychiatric Interview (MINI). Data were collected with a designed questionnaire and proforma of cardiovascular indices assessed at baseline, 1 and 3 months visits. (test of significance was set at 0.05).

The mean age of participants was 32.41 ± 7.33 years. Three-quarter, 78.1% of the participants were on atypical antipsychotics. There are significant increase in mean differences of Blood Pressure and Electrocardiogram changes from baseline to 3 months following initiation of antipsychotics; SBP (117.96 ± 8.00 to 129.31 ± 13.54, F = 34.03, P < 0.001), QRS duration (105.14 ± 34.40 to 111.87 ± 37.24, F = 21.7. P < 0.001) and PR interval (155.84 ± 24.27 to 165.85 ± 27.71, F = 74.25, P < 0.001). The differences in type of antipsychotics (typical > atypical) had a greater significant effect on the mean SBP (T - test = 2.27, P = 0.02) and mean P-wave axis (T - test = 2.60, P = 0.01).

Antipsychotics increased cardiovascular indices post baseline. The typical antipsychotics significantly increased the SBP and P-wave axis of ECG compared to the atypical antipsychotics. Atypical antipsychotics and regular cardiovascular indices monitoring is advocated.