Effects of Newer Atypical Antipsychotics on Autonomic Neurocardiac Function: A Comparison Between Amisulpride, Olanzapine, Sertindole, and Clozapine
Abstract
As part of a prospective clinical study investigating the effects of atypical neuroleptics on autonomic neurocardiac function (ANF), serial standardized recordings of conventional electrocardiograms and computer-calculated measurements of 5-minute resting heart rate variability (HRV) were obtained from 51 medication-free inpatients with schizophrenia (DSM-III-R-diagnosed) before and after an average of 14.1 days of treatment with amisulpride 400 mg/day (N = 12), olanzapine 20 mg/day (N = 13), sertindole 12 mg/day (N = 13), or clozapine 100 mg/day (N = 13). Reference values for the HRV data were obtained from a large group of well-matched healthy controls (N = 70). The most important findings were the following: (1) clozapine, olanzapine, and sertindole all prolonged mean frequency-corrected QTc times, which, in the case of sertindole, proved to be significant (Wilcoxon test p <0.05); (2) sertindole and clozapine significantly increased the mean resting heart rate; and (3) only clozapine significantly reduced the parasympathetic resting tone. The results of the HRV studies are discussed considering the in vitro receptor profiles of the atypical neuroleptics under study. Potential implications for the cardiac safety and tolerance of these drugs are also discussed.
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Because both first-generation and second-generation antipsychotics modulate serotonergic, dopaminergic, cholinergic and adrenergic neurotransmitter systems, it is likely that antipsychotics influence autonomic neurocardiac functioning.
“However, given that both first-generation and second-generation APs modulate serotonergic, dopaminergic, cholinergic and adrenergic neurotransmitter systems, it is likely that APs influence autonomic neurocardiac functioning42”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [42]
Amisulpride does not have cholinergic or adrenergic properties and has no significant effects on autonomic function.
“Amisulpride does not have any cholinergic or adrenergic properties and has no significant effects on autonomic function42.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [42]
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- Authors
- Agelink, M. W., Majewski, T., Wurthmann, C., Lukas, K., Ullrich, H., Linka, T., & Klieser, E.
- Affiliations
- Evangelische Kliniken Gelsenkirchen (DE)
- University of Duisburg-Essen (DE)
- Corresponding author
- Agelink, Marcus W.
- Lukas, K.
- Ullrich, H.
- Linka, T.
- Klieser, E.
- ORCID
- Klieser, E.
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2001-02
- Volume
- 21
- Issue
- 1
- Pages
- 8-13
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W2322918825
- Cited by
- 166
- References
- 35
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 10 · 2017: 8 · 2016: 7 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 11
- FWCI
- 7.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atypical antipsychotics, heart rate variability, QTc prolongation, sertindole, clozapine, olanzapine, amisulpride, schizophrenia, cardiac safety, parasympathetic activity, resting heart rate
- MeSH terms
- Olanzapine, Amisulpride, Adult, Autonomic Nervous System, Benzodiazepines, Clozapine, Electrocardiography, Female, Heart, Heart Rate, Humans, Imidazoles, Indoles, Male, Middle Aged, Pirenzepine, Prospective Studies, Sulpiride, Antipsychotic Agents
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