Psychotropic Medications and Heart

Abstract

Knowledge of cardiac actions and adverse effects of psychotropic medications is essential for safe prescribing of medications and take informed decisions in a clinically defensible manner. The main groups of psychotropic medications (antipsychotics, antidepressants, and mood stabilizers) have actions on cardiac conduction, rhythm, blood pressure; and are associated with potentially serious cardiovascular side-effects. They are occasionally associated with serious adverse events such as myocarditis and cardiomyopathy. Second-generation antipsychotics and antidepressants are routinely prescribed as first-line treatments for psychiatric conditions, but they are also associated with cardiovascular side-effects and, in case of some of second-generation antipsychotics, higher burden of cardiometabolic side-effects. Once started on treatment, careful monitoring and vigilance is required. This article summarizes the cardiovascular side-effects associated with the three major classes of psychotropic medications and makes recommendations about cardiovascular monitoring during treatment.