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Atypical Antipsychotic Medications Disrupt the Cardio-Metabolic and Cardio-Immune Axes

B Rostama, M May, KL Houseknecht

Antipsychotic medications, including atypical antipsychotics (AA), are widely prescribed and are associated with significant cardiometabolic side effects. It has been known for some time that AA cause drug-induced tachycardia, weight gain, dyslipidemia and hyperglycemia, and AA use in older adults is associated with increased risk of mortality, largely due to MI or stroke. The pharmacological mechanisms underlying these diverse adverse events are largely unknown. AA drugs are also associated with increased risk of infections, in patients across age ranges and regardless of diagnosis. Emerging evidence indicates that AA medications may have anti-inflammatory and immune dysregulatory properties, which may contribute to medication efficacy for schizophrenia and psychosis and increase susceptibility to infection. The role of antipsychotics in modulating the cardio-immune axis is largely unknown. In this review, we will highlight new data which shed light on potential mechanisms and implications for prescribing and patient care.