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

Abstract

BACKGROUND: Antipsychotic medications increase cardiovascular diseases beyond schizophrenia. This effect is worsened by the kind of antipsychotics used. AIM: To determine the cardiovascular changes due to antipsychotics in schizophrenic patients in tertiary hospitals in Enugu State, Nigeria. MATERIALS AND METHODS: 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). RESULTS: 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). CONCLUSION: 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.