Heart meds side effects
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Side Effects of Heart Medications: A Comprehensive Overview
Antipsychotic Medications and Cardiovascular Risks
Atypical Antipsychotics and Cardiac Proteomic Changes
Atypical antipsychotic (AA) medications, such as risperidone (RIS) and olanzapine (OLAN), are known to increase the risk of cardiovascular diseases. These medications can lead to obesity, insulin resistance, dyslipidemia, and hypertension. Research has shown that RIS and OLAN alter the cardiac proteomic signature in mice, affecting mitochondrial function and oxidative phosphorylation, which may contribute to adverse cardiac outcomes1.
Orthostatic Hypotension and QTc Prolongation
Psychotropic drugs, including antipsychotics, commonly cause orthostatic hypotension, particularly with clozapine and low potency agents. QTc prolongation, a marker of arrhythmic risk, is another significant side effect, with drugs like pimozide, thioridazine, sertindole, and zotepine posing higher risks. These conditions can lead to severe arrhythmias, syncope, and even sudden death7.
Herbal Medicines and Cardiovascular Adverse Effects
Serious Cardiovascular Events
Herbal medicines, though popular, can have serious cardiovascular side effects. These include arrhythmias, arteritis, cardiac glycosides overdose, chest pain, congestive heart failure, hypertension, hypotension, myocardial infarction, over-anticoagulation, pericarditis, and death. The risks are often due to toxic ingredients, adulteration, contamination, and herb-drug interactions2.
Cancer Chemotherapy and Cardiotoxicity
Anthracyclines and Targeted Therapies
Cancer chemotherapy, particularly with anthracyclines, can cause oxidative stress and apoptosis, leading to cardiac toxicity. Targeted therapies, such as tyrosine kinase inhibitors (TKIs) like trastuzumab, imatinib mesylate, and sunitinib, can induce heart failure or asymptomatic left ventricular dysfunction. These side effects necessitate careful cardiac monitoring and management by cardiologists3 5.
Antidepressants and Cardiovascular Effects
Tricyclic Antidepressants (TCAs) and Newer Agents
Tricyclic antidepressants (TCAs) have significant cardiovascular effects, including increased heart rate, postural hypotension, and QT interval prolongation. In toxic doses, they can cause advanced heart block and ventricular arrhythmias. Newer antidepressants, such as fluvoxamine, have fewer cardiovascular effects, though they may still cause minor heart rate changes6 10.
Nitrates in Heart Failure and Acute Coronary Syndromes
Common Side Effects
Nitrates, used to treat heart failure and acute coronary syndromes, commonly cause headaches, hypotension, and dizziness. Severe hypotension can occur, especially with concomitant use of phosphodiesterase-5 inhibitors or in patients with right ventricular dysfunction. Despite these side effects, nitrates remain a critical component of heart failure management9.
Conclusion
Heart medications, including antipsychotics, herbal medicines, cancer chemotherapies, antidepressants, and nitrates, can have significant cardiovascular side effects. These range from mild symptoms like headaches and dizziness to severe conditions such as heart failure, arrhythmias, and sudden death. Careful monitoring and management by healthcare professionals are essential to mitigate these risks and ensure patient safety.
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Most relevant research papers on this topic
Exploring mechanisms of increased cardiovascular disease risk with antipsychotic medications: Risperidone alters the cardiac proteomic signature in mice.
Risperidone and olanzapine treatment in mice leads to altered cardiac proteomic signatures, which may contribute to increased cardiovascular disease risk.
Non-RCT
Animal Study
Rigorous JournalCardiovascular adverse effects of herbal medicines: a systematic review of the recent literature.
Herbal medicines, particularly aconite, ephedra, and licorice, are regularly associated with serious cardiovascular adverse events, but the size of the problem cannot currently be estimated.
Systematic Review
Highly CitedCardiac side-effects of cancer chemotherapy.
Cancer chemotherapy can cause cardiac side-effects, and early detection and management of these risks is crucial for optimal patient outcomes.
Highly CitedToward a broader view of mechanisms of drug cardiotoxicity
Drug cardiotoxicity involves a broad range of mechanisms, including contractility, mitochondrial function, and cellular signaling, affecting various organ systems.
Very Rigorous JournalCardiotoxicity induced by tyrosine kinase inhibitors
Cardiac toxicity can occur with tyrosine kinase inhibitors, requiring careful monitoring and assessment by a cardiologist during treatment.
Literature ReviewHighly CitedCardiac effects of antidepressant drugs. A comparison of the tricyclic antidepressants and fluvoxamine.
Tricyclic antidepressants have significant cardiovascular effects, while fluvoxamine has no significant cardiovascular effects except for slightly slowing the heart rate.
Cardiac side effects of psychiatric drugs
Psychotropic drugs can cause common cardiovascular side effects, including orthostatic hypotension, QTc prolongation, and heart muscle disease, with clozapine treatment linked to rare complications.
Literature ReviewHighly Cited