Management of schizophrenia with medical disorders: cardiovascular, pulmonary, and gastrointestinal.
Medical illnesses are particularly common in patients who have schizophrenia and one of the major tasks for consultation-liaison psychiatrists, and others, is to determine which medications are safest in which co-morbid condition. The authors review the relative risks for various antipsychotics, especially focusing on cardiovascular, pulmonary, and gastrointestinal co-morbid illnesses. The authors further review the atypical antipsychotics' cardiovascular risks, especially for prolonging QT intervals, in trying to avoid the risk for torsades de pointes. The relative risk for anticholinergic actions for these medicines is also reviewed, as this is especially important in the medically ill or elderly. The authors also review the relative safety of antipsychotics in patients who have liver disease and pulmonary disease. Finally, the authors review specific drug interactions that may be problematic when treating the medically ill with atypical antipsychotics.
Short
Delmar D
DD
Mental Health Service Line (116A), Department of Veterans Affairs Medical Center, Salem, VA 24153, USA. Delmar.Short@va.gov
Hawley
Joanne M
JM
McCarthy
Maureen F
MF
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications*; D004347:Drug Interactions; D004637:Emergency Services, Psychiatric / Q000379:methods; D005767:Gastrointestinal Diseases / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*
D014150:Antipsychotic Agents