Short time on antipsychotics may up heart disease

By Leigh Krietsch Boerner

NEW YORK (Reuters Health) - Antipsychotic medications, which have raised red flags in the past, may increase the risk of heart disease in as little as a few months, a new study says.

Among the people taking these drugs are patients with schizophrenia, who tend to have shorter-than-average life spans. So the role of antipsychotics in heart disease needs to be addressed, said co-author Debra Foley, senior lecturer at the Center for Youth Mental Health at the University of Melbourne in Australia.

Researchers have already reported that newer antipsychotics are associated with an increased risk of diabetes. The Food and Drug Administration put out warnings on this danger in 2004.

According to the new study, published in the Archives of General Psychiatry, patients taking antipsychotics tended to gain weight after one month and had increases in their cholesterol levels after three to four months.

Obesity, high cholesterol, and diabetes all increase the risk of heart disease.

"This change in risk is evident early in the course of treatment, within several weeks of continuous use, but may continue to alter over several years," Foley told Reuters Health in an email. The "risk varies depending on the specific drug taken and how long it is taken for," she added.

About one in 100 adults in the U.S. has schizophrenia, according to the National Institute of Mental Health.

But antipsychotic drugs are also given to some patients with bipolar disorder, personality disorders, or anxiety, said Dr. Karen Graham, assistant professor of psychiatry at the University of North Carolina School of Medicine. She was not involved in the study.

The drugs in Foley's study included Janssen's Risperdal, and Lilly's Zyprexa, among others.

"Lilly is confident in the overall benefit-risk profile of Zyprexa," a company spokesman told Reuter's Health in an email.

Zyprexa has been prescribed for an estimated 28 million patients around the world, and a large amount of evidence shows the drug is safe for the uses for which it's been approved, Lilly said.

Foley and her team looked at 25 previous studies that had tracked risk factors for heart disease in patients taking older or newer antipsychotics. These included high blood pressure, cholesterol levels, and body weight.

They found that across all the studies, six to seven of every 10 people on antipsychotics were overweight after six months. Before taking the drugs, only about four of every 10 were overweight, the same as in the general population.

This is important because these are generally young and otherwise healthy people, Graham said.

Researchers don't know why these drugs can increase heart disease risk, but a recent study showed they can affect how the body manages cholesterol, Foley said.

Both patients and doctors should be aware of the increased heart disease risk, Foley said, and work together to minimize the patient's risk.

SOURCE: bit.ly/hba3GD Archives of General Psychiatry, online February 7, 2011.