Atypical Antipsychotics Linked to Heart Failure
> 1/16/2009 6:51:15 PM

Next-generation antipsychotic drugs have been linked, in a disturbing New England Journal of Medicine study, to a 200% greater chance of heart failure and sudden death. This news will certainly serve as a setback for a wave of drugs touted as safer and more effective than their predecessors, but it's not an entirely new revelation: older antipsychotics have long been linked to potentially fatal cardiovascular problems and most experts have warned against prescribing next-generation drugs like Zyprexa and Seroquel to elderly dementia patients due to potentially fatal risks detailed in previous studies. 


The exhaustive research project involved the records of 93,300 medicated patients and twice as many control subjects. In the name of accuracy, researchers found two subjects with identical demographic variables for each medicated individual. The medicated group also included nearly as many individuals who were still taking the older medications so that researchers could compare outcomes of both typical and atypical drugs. Subjects with pre-existing heart conditions or related diseases were disqualified. Researchers found that the number of deaths by cardiac arrest in the medicated group during the period in question was double that of the control group and that the statistics were identical whether the subjects took first or second-generation drugs. They also found the degree of risk to increase with the size of each regular dose, leaving no doubt that these drugs were directly responsible for incidents of cardiac arrest.


While the risk has been classified as "low" or "moderate" by researchers, they estimate in a subsequent editorial that 1 out of every 1,000 patients taking atypical antipsychotics in a given year will die of drug-induced heart failure. Over a 10-year period 3% of all medicated patients will die. Those numbers, while small, remain disturbing, and the study's clear conclusion is that the new antipsychotics are no safer than their predecessors. The reasons for the dangers they pose center on the body's inability to process such heavy doses of a foreign substance and the new meds fail to transcend those limitations. The same incompatibility principle lies behind the dramatic weight gain exhibited by so many medicated schizophrenic subjects. These problems are particularly pronounced among the young and the elderly, whose bodies are less resilient, and the fact that the study's youngest participants were 30 years old reinforces the fact that these medicines are never appropriate for children. 


A wave of bad news regarding antipsychotic medications does not negate the fact that pharmaceutical-free treatment is not an option for seriously affected individuals. These new findings only make adherence to a healthy lifestyle even more important for those taking any kind of medicine for psychosis. The practices of maintaining a healthy, low-fat diet, abstaining from tobacco use and exercising moderately each day can be just as helpful for schizophrenic or bipolar subjects as they can for the general populace. Researchers also recommend twice-daily EKGs to measure the heart rates of medicated patients before and after they take their drugs because abnormalities may be apparent before heart failure when emergency treatment is still an option. Doctors may need to be even more conservative with their prescriptions in the future as individuals who are already suffering from heart disease should probably not take high doses of Zyprexa or Seroquel. But few viable alternatives exist. And foregoing treatment is not an option. 


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