Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder. (3rd January 2014)

• Record Type: Journal Article
• Authors: Linder, Jonathan R.; Sodhi, Simrit K.; Haynes, William G.; Fiedorowicz, Jess G.
• Is Part Of: Human psychopharmacology. Volume 29:Number 2(2014:Mar.)
• Page Start: 145
• Page End: 151
• Publication Date: 2014-01-03
• Subjects: Psychopharmacology -- Periodicals; Psychotropic drugs -- Periodicals; Psychopharmacology -- Periodicals; Psychotropic Drugs -- pharmacology -- Periodicals; 615.78
• DOI: 10.1002/hup.2380
• Languages: English
• ISSNs: 0885-6222

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hup2380-sec-0001" sec-type="section"> <title>Objective</title> <p>The risk for cardiovascular diseases is elevated in persons with bipolar disorder. However, it remains unknown how much of this excess risk is secondary to pharmacologic treatment. We tested the hypothesis that current and cumulative antipsychotic drug exposure is associated with increased cardiovascular risk as indicated by lower heart rate variability (HRV) and increased blood pressure variability (BPV).</p> </sec> <sec id="hup2380-sec-0002" sec-type="section"> <title>Methods</title> <p>Fifty‐five individuals with bipolar disorder (33 ± 7 years; 67% female) underwent noninvasive electrocardiogram assessment of time‐domain and frequency‐domain HRV, as well as BPV analysis. Medication histories were obtained through systematic review of pharmacy records for the past 5 years.</p> </sec> <sec id="hup2380-sec-0003" sec-type="section"> <title>Results</title> <p>Current antipsychotic exposure was associated with lower standard deviation of NN intervals. Second‐generation antipsychotics were associated with lower standard deviation of NN intervals and root mean square of successive differences. There was no significant relationship between 5‐year antipsychotic exposure and HRV in subjects with bipolar disorder. Exploratory analysis revealed a possible link between selective serotonin reuptake inhibitor exposure and increased low‐frequency spectral HRV.</p> </sec> <sec id="hup2380-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Current antipsychotic use (particularly second‐generation antipsychotics with high affinities for the D<sub>2S</sub> receptor) is associated with reduced autonomic‐mediated variability of the HR. The absence of an association with cumulative exposure suggests that the effects are acute in onset and may therefore relate more to altered autonomic function than structural cardiovascular abnormalities. Future studies should prospectively examine effects of these antipsychotics on autonomic function. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>