Psychotropic medication and the heart: Part 1

Severe mental illness is associated with increased morbidity and mortality, primarily due to premature cardiovascular disease.


The cardiovascular events are strongly linked to non-modifiable as well as modifiable risk factors, such as obesity, dyslipidemia, diabetes, hypertension and smoking (Saravane et al, 2009).


There is also evidence of an association between severe mental illness and the modifiable risk factors in heart disease. Indeed, studies have reported evidence of increased risk of heart disease in patients with depression (De Hert et al, 2009). Many psychotropic medications are also associated with ECG changes.


Evidence suggests that computerised readings of ECGs are not always accurate (Willems et al,1991). It is therefore essential that psychiatrists are aware of the potential adverse effects of psychotropic medication on the heart and that they improve their skills in reading and interpreting ECGs.


In this module we will consider:


  • the normal findings of an ECG


  • the ECG findings in angina and myocardial infarction


  • the effects of psychotropic medication on heart rate


  • the effects of psychotropic medication on blood pressure


  • antidepressant use in coronary heart disease.


Start the module


If you like this module, you may also be interested in:


Psychotropic medication and the heart: Part 2 by Dr Sridevi Sira Mahalingappa, Professor Femi Oyebode and Dr Patrick O'Brien


Don't shrink... from ECGs: Part 1 and Part 2 by Dr Luke Solomons, Dr Jim Crabb and Dr Adrian Treloar


Managing depression in physical illness by Dr Janet Butler and Dr Annabel Price


Pharmacological treatment of resistant depression an overview

by Professor Philip J. Cowen



BJPsych Advances: related articles for CPD Online



Related Advances articles


Download take-home notes to print and annotateDownload take-home notes to print and annotate


In the second module in this series, Psychotropic medication and the heart: Part 2, we will look at the effect of psychotropic medication on normal heart functioning, cardiac rhythm, cardiac muscle and contractility.



© 2020 Royal College of Psychiatrists