Antipsychotic medication influences cardiovascular coupling in patients suffering from acute schizophrenia

Schizophrenia (SZO) is one of the most serious mental illnesses in the world associated with the risk for cardiovascular events. The aim of this study was to quantify and characterize how different antipsychotics influence short-term cardiovascular couplings (CVC) in acute SZO. In this study CVC of 42 unmedicated (UNMED), 42 medicated (MED) patients suffering from SZO and 42 age and gender matched healthy subjects (CON) was analyzed applying the High Resolution Joint Symbolic Dynamics. We found decreased CVC in SZO (UNMED, MED) characterized by CVC patterns that were less predominant and more distributed in comparison to CON and mainly dominated by a greater amount of slow increasing, slow decreasing, alternating and fluctuating systolic blood pressure in combination with invariable heart rate responses. The impairment of the cardiovascular system in SZO was much more formed in MED and seems to be due to the anti-cholinergic effects of antipsychotics. Especially, a subgroup of MED treated with clozapine, quetiapine and amisulpride had the strongest influence on CVC than those treaded with olanzapine. These results might contribute to an optimal selection of therapy strategies minimizing cardiovascular pro-arrhythmic effects in SZO and thus to a more individual patient adapted therapy.