Acute Blood Pressure Changes Associated With Antipsychotic Administration to Psychiatric Inpatients

Parks, Kristin A.; Parks, Clayton G.; Yost, Johnathon P.; Bennett, Jeffrey I.; Onwuameze, Obiora E.

doi:10.4088/pcc.18m02299

Cited by 16 publications

(11 citation statements)

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“…The female patients seemed to have more stable readings of blood pressure, despite the long-term use of SGAs. Parks et al reported an acute decrease in blood pressure in patients three days post-initiation of SGA [42]. Moreover, mean systolic blood pressures were found to have had slightly decreased after 12 months of SGA use [43].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population

et al. 2019

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Objectives: The aim of this study was to determine the incidence of metabolic syndrome in patients treated with second-generation antipsychotics (SGAs). Methods: In this retrospective study, we reviewed patients’ electronic medical records (EMRs) of all patients who received one SGA for at least six months, excluding patients who were taking other medications that are associated with significant effect on metabolic syndrome. Relevant clinical information was collected prior to starting the SGA and after six months of continuous use of the same SGA. Results: A total of 91 patients were included in the study. The majority of patients (72%) were diagnosed with schizophrenia. After six months of taking the SGA, 44% of patients experienced elevated systolic pressure, 54.9% had elevated triglyceride, and 31.9% had impaired glucose levels (p value < 0.05). Prior to initiating SGA therapy, 14.3% of patients had metabolic syndrome, while 37.4% had metabolic syndrome after six months of therapy, and it was more prominent in males compared to female patients (p value < 0.05). Conclusion: This study found a strong correlation between SGA use and the appearance of metabolic alterations, such as weight gain, glucose intolerance, and increased triglyceride levels. These findings highlight the importance of assessing metabolic deregulations to minimize SGA associated metabolic abnormalities.

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Section: Discussionmentioning

confidence: 99%

The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population

et al. 2019

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“…In patients diagnosed with schizophrenia, short-term treatment (3 days) with clozapine induced transient hypotension (Parks et al, 2018), most likely due to direct α1 adrenergic receptor antagonism. During 8 weeks of clozapine treatment, heart rate increased and blood pressure shifted toward hypertension (Norman et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Activation of the aryl hydrocarbon receptor by clozapine induces preadipocyte differentiation and contributes to endothelial dysfunction

et al. 2022

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Background: The superior therapeutic benefit of clozapine is often associated with metabolic disruptions as obesity, insulin resistance, tachycardia, higher blood pressure, and even hypertension. Aims: These adverse vascular/ metabolic events under clozapine are similar to those caused by polycyclic aromatic hydrocarbons (PAHs), and clozapine shows structural similarity to well-known ligands of the aryl hydrocarbon receptor (AhR). Therefore, we speculated that the side effects caused by clozapine might rely on AhR signaling. Methods: We examined clozapine-induced AhR activation by luciferase reporter assays in hepatoma HepG2 cells and we proved upregulation of the prototypical AhR target gene Cyp1A1 by realtime-PCR (RT-PCR) analysis and enzyme activity. Next we studied the physiological role of AhR in clozapine’s effects on human preadipocyte differentiation and on vasodilatation by myography in wild-type and AhR-/- mice. Results: In contrast to other antipsychotic drugs (APDs), clozapine triggered AhR activation and Cyp1A1 expression in HepG2 cells and adipocytes. Clozapine induced adipogenesis via AhR signaling. After PGF2α-induced constriction of mouse aortic rings, clozapine strongly reduced the maximal vasorelaxation under acetylcholine in rings from wild-type mice, but only slightly in rings from AhR-/- mice. The reduction was also prevented by pretreatment with the AhR antagonist CH-223191. Conclusion: Identification of clozapine as a ligand for the AhR opens new perspectives to explain common clozapine therapy-associated adverse effects at the molecular level.

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“…The effect of antipsychotic medications on blood pressure is not clear. A retrospective study found that olanzapine and risperidone raised blood pressure during the first three days after initiation, but clozapine reduced blood pressure (18). Prospective studies are required for further evaluation of this, but even if there is not a direct effect on blood pressure, medication-induced weight gain will contribute to an increased risk of hypertension.…”

Section: Contribution Of Antipsychotic Medications To Metabolic Syndrome Componentsmentioning

confidence: 99%

The Biopsychosocial Model Advanced by Evolutionary Theory

Egan¹,

Doherty²

2022

Evolutionary Psychiatry

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Acute Blood Pressure Changes Associated With Antipsychotic Administration to Psychiatric Inpatients

Abstract: Initiation of certain antipsychotic medications may be associated with statistically significant acute BP changes. These findings require further evaluation in well-designed prospective studies.

Cited by 16 publications

References 0 publications

The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population

The Effect of Long-Term Second-Generation Antipsychotics Use on the Metabolic Syndrome Parameters in Jordanian Population

Activation of the aryl hydrocarbon receptor by clozapine induces preadipocyte differentiation and contributes to endothelial dysfunction

The Biopsychosocial Model Advanced by Evolutionary Theory

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