Antipsychotics cardiotoxicity: What's known and what's next.

Abstract

Chronic use of antipsychotic medications entails a dilemma between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects. Antipsychotic-induced cardiotoxicity is one of the most life-threatening adverse effects that raises widespread concerns. These cardiotoxic effects range from arrhythmia to heart failure in the clinic, with myocarditis/cardiomyopathy, ischemic injuries, and unexplained cardiac lesions as the pathological bases. Multiple mechanisms have been proposed to underlie antipsychotic cardiotoxicity. This review aims to summarize the clinical signs and pathological changes of antipsychotic cardiotoxicity and introduce recent progress in understanding the underlying mechanisms at both the subcellular organelle level and the molecular level. We also provide an up-to-date perspective on future clinical monitoring and therapeutic strategies for antipsychotic cardiotoxicity. We propose that third-generation antipsychotics or drug adjuvant therapy, such as cannabinoid receptor modulators that confer dual benefits - i.e., alleviating cardiotoxicity and improving metabolic disorders - deserve further clinical evaluation and marketing.

• Authors: Xiao-Qing Li, Xin-Ru Tang, Li-Liang Li
• Journal: World journal of psychiatry (World J Psychiatry) Vol. 11 Issue 10 Pg. 736-753 (Oct 19 2021) ISSN: 2220-3206 [Print] United States
• PMID: 34733639 (Publication Type: Journal Article, Review)
• Copyright: ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.