ArticleBMJ mental health2023
Associations between antipsychotics and the risk of incident cardiovascular diseases in individuals with schizophrenia: a nested case-control study.
Article in BMJ mental health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 10 citations in OpenAlex.
- Early Corrected QT Interval Changes Following First-dose Long-acting Injectable Antipsychotics: A Retrospective Inpatient Study.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- The bidirectional mechanistic links between Alzheimer's disease and cardiovascular disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Mental Disorders as Risk Factors for New Onset Cardiovascular Diseases.Biomedicines · 2026Review
- Psychopharmacological Treatment in Patients with Heart Failure: A Narrative Review of Mood Stabilizers and Antipsychotics.Brain sciences · 2026Review
- Evaluation of Prescription Patterns of Antipsychotics in Schizophrenia Patients-A Single-Center Prospective Study.Journal of clinical medicine · 2025Article
- Neural network analysis of the contribution of psychotropic prescription sequences to the risk of non-psychiatric adverse events in bipolar and schizophrenia spectrum disorders.Frontiers in digital health · 2025Article
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between antipsychotics and cardiovascular diseases (CVDs) remains significant yet unestablished, especially in Chinese populations.
objectiveTo investigate the risk of CVDs associated with antipsychotics among Chinese individuals with schizophrenia.
methodsWe conducted a nested case-control study on individuals diagnosed with schizophrenia in Shandong, China. The case group included individuals diagnosed with incident CVDs between 2012 and 2020. Each case was randomly matched with up to three controls. We used weighted logistic regression models to assess the risk of CVDs associated with antipsychotics and restricted cubic spline analysis to explore the dose-response relationship.
findingsIn total, 2493 cases and 7478 matched controls were included in the analysis. Compared with non-users, any antipsychotics use was associated with higher risk of any CVDs (weighted OR=1.54, 95% CI 1.32 to 1.79), with the risk mainly driven by ischaemic heart diseases (weighted OR=2.26, 95% CI 1.71 to 2.99). Treatments with haloperidol, aripiprazole, quetiapine, olanzapine, risperidone, sulpiride and chlorpromazine were associated with increased risk of CVDs. A non-linear dose-response relationship between dosage of antipsychotics and risk of CVDs was observed, with a sharp increase in risk in the beginning and then flattening out with higher doses.
conclusionsUse of antipsychotics was associated with increased risk of incident CVDs among individuals with schizophrenia, and the risk varied substantially among different antipsychotics and specific CVDs. CLINICAL IMPLICATIONS: Clinicians should consider the cardiovascular risk of antipsychotics and choose the appropriate type and dose of drugs in the treatment of schizophrenia.
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