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Cited by 57Cardiac electrophysiology and arrhythmiasSchizophrenia research and treatmentCardiac Health and Mental Health

Antipsychotic drugs and sudden cardiac death: A literature review of the challenges in the prediction, management, and future steps

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Zhu, Jingjing, Hou, Weihong, Xu, Yong, Ji, Feng, Wang, Guowei, Chen, Ce, Lin, Chongguang, Lin, Xiodong +3 more·2019·Psychiatry Research
DOI 10.1016/j.psychres.2019.112598
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Abstract

Sudden cardiac death (SCD) is relatively uncommon, yet it is a deadly consequence of some antipsychotic medications in patients with psychiatric disorders. The widespread concerns about the adverse cardiac effects associated with antipsychotics and their unpredictable nature have led to a restriction on the use of some antipsychotic medications. Recent progress has been made in the identification of important genetic factors that may contribute to the adverse complication of antipsychotic drugs, suggesting that high-risk individuals can be identified prior to initiating therapy. In addition, some high-tech smart wearable medical devices have recently been developed, allowing users to record and analyze the electrocardiogram (ECG) in couple with artificial intelligence (AI) technologies, and notifying of irregular heart rhythms or arrhythmias, a medical condition well documented in most SCD cases. In this literature review, we summarize recent advances in understanding the link between SCD and antipsychotic drug usage, as well as in utilizing wearable medical devices for monitoring of cardiac arrhythmias. New strategies for improving the care of patients receiving antipsychotic medications are proposed. As it is now possible to evaluate the risk of SCD in patients on antipsychotic medications, preventative measures and close monitoring may be used to detect the early signs of adverse cardiac events and SCD.

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  • Both first-generation and second-generation antipsychotics can prolong cardiac repolarization (QT interval), increasing the risk of ventricular arrhythmias such as torsades de pointes.

    “Both first-generation (typical) and second-generation (atypical) antipsychotics can prolong cardiac repolarization (QT interval), increasing the risk of ventricular arrhythmias such as torsades de pointes [27,28].”

    From Trends in Sudden Death Among Schizophrenia Inpatients (2025) · cites this paper as [28]

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Authors
Zhu, J., Hou, W., Xu, Y., Ji, F., Wang, G., Chen, C., Lin, C., Lin, X., Li, J., Zhuo, C., & Shao, M.
Affiliations
  • Wenzhou Seventh People's Hospital (CN)
  • Zhengzhou University (CN)
  • Shanxi Medical University (CN)
  • Jining Medical University (CN)
  • Linyi People's Hospital (CN)
  • Nankai University (CN)
  • China-Japan Friendship Hospital (CN)
Corresponding author
Zhuo, Chuanjun
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2019-11
Volume
281
Pages
112598
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2019.112598
OpenAlex
W2978735198
Cited by
56
References
71
Citations by year
2026: 2 · 2025: 10 · 2024: 8 · 2023: 9 · 2022: 14 · 2021: 8 · 2020: 5
FWCI
1.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychiatry Research (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
National Natural Science Foundation of China
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
antipsychotic drugs, sudden cardiac death, cardiac side effects, genetic risk factors, cardiac arrhythmias, wearable medical devices, ECG monitoring, artificial intelligence, risk prediction, patient monitoring, mental illness
MeSH terms
Arrhythmias, Cardiac, Behavior Therapy, Mental Disorders, Electrocardiography, Forecasting, Humans, Predictive Value of Tests, Risk Factors, Antipsychotic Agents, Death, Sudden, Cardiac, Disease Management

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