Managing the cardiovascular time bomb in patients on antipsychotics

The physical health of mentally ill patients is a “massive problem and we are doing very badly at it,” psychiatrist Dr Matthew Warden told doctors at a recent Healthed evening seminar in Sydney.

In particular, the prevalence of high cardiovascular risk among patients with a history of psychosis, means this population was a “ticking time bomb”, said Dr Warden, who is the Director of Acute Inpatient Services for Mental Health at St Vincent’s Hospital in Melbourne.

Even without antipsychotic medication, a disproportionate number of people with a history of psychosis are overweight or obese, do very little if any physical exercise and smoke.

And it is well-known that the metabolic side-effects associated with antipsychotic medications increases this cardiovascular risk enormously.

Consequently, there has been growing pressure on psychiatrists to assess, monitor and manage the physical health of their patients with psychosis, but Dr Warden said, realistically this needs to be also done by GPs as they will usually be managing these patients long-term ...

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