Division of Cardiology, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Expert Opin Drug Saf. 2020 May;19(5):559-564. doi: 10.1080/14740338.2020.1745184. Epub 2020 Apr 15.
: Increased mortality has been observed in patients with mental health disorders. Specifically, exposure to antipsychotic medications conveys a greater than 2 fold risk of sudden death, thought to be mediated through effects on QT prolongation and risk of torsades de pointes.: We review the association between antipsychotic drugs and sudden cardiac death, the physiologic basis for these associations, assessment of patients at risk, and strategies to minimize risk of sudden cardiac death.: Despite the prevalence of antipsychotic medication use for many decades, there remain considerable challenges in reducing the associated risk of sudden cardiac death. A structured algorithm that incorporates patient clinical factors and antipsychotic drug factors may improve risk assessment and reduce the risk of adverse cardiac events. Future advancements in genetics and artificial intelligence may allow for enhanced risk stratification and predicting response (efficacy and adverse effects) to therapy.
精神疾病患者的死亡率增加。具体来说,抗精神病药物的暴露导致猝死的风险增加了两倍以上,据认为这是通过对 QT 延长和尖端扭转型室性心动过速的风险的影响介导的。我们回顾了抗精神病药物与心源性猝死之间的关联,这些关联的生理基础,风险患者的评估以及降低心源性猝死风险的策略。尽管抗精神病药物的使用已经流行了几十年,但在降低相关心源性猝死风险方面仍存在许多挑战。一种包含患者临床因素和抗精神病药物因素的结构化算法可能会改善风险评估并降低不良心脏事件的风险。遗传和人工智能的未来进步可能会实现风险分层和预测治疗的反应(疗效和不良反应)。