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Dose-dependent effect of antipsychotic drugs on autonomic nervous system activity in schizophrenia.doc

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Dose-dependent effect of antipsychotic drugs on autonomic nervous system activity in schizophrenia

Iwamotoetal.BMCPsychiatry2012,12:199 /1471-244X/12/199 RESEARCH ARTICLE OpenAccess Dose-dependenteffectofantipsychoticdrugs onautonomicnervoussystemactivity inschizophrenia YohkoIwamoto1,2,ChiakiKawanishi1*,IkukoKishida1,2,TakuFuruno1,MamiFujibayashi3,4,ChieIshii2,NorioIshii2, ToshioMoritani3,MasatakaTaguri5andYoshioHirayasu1 Abstract Background:Antipsychoticdrugsareconsideredatriggerfactorforautonomicdysregulation,whichhasbeen showntopredictpotentiallyfatalarrhythmiasinschizophrenia.However,thedose-dependenteffectof antipsychoticdrugsandotherpsychotropicdrugsonautonomicnervoussystem(ANS)activityremainunclear. Thepurposeofthisstudywastoinvestigatethedose-dependenteffectofantipsychoticdrugsandotherclinical factorsonANSactivityinanadequatesamplesizeofpatientswithschizophrenia. Methods:Atotalof211Japanesepatientswithschizophreniaand44healthysubjectsparticipatedinthisstudy. ANSactivitywasassessedbymeansofheartratevariability(HRV)powerspectralanalysis.Antipsychoticdrug treatmentandvariousclinicalfactorswereinvestigatedforeachparticipant.Thepatientgroupwascategorizedinto threesubgroupsaccordingtodailydoseofantipsychoticdrug,andHRVwascomparedbetweengroups. Results:Theresultsshowedsignificantlydecreasedlow-frequencyandhigh-frequencycomponentsofHRVinthe patientgroupcomparedtothecontrolgroup.Thehigh-dosegroupshowedasignificantlylowerHRVthanthe medium-dosegroupandanevenlowerHRVthanthelow-dosegroup.Inaddition,asignificantassociation betweenHRVandantipsychoticdrugdosewasidentifiedbymultipleregressionanalysis.HRVwasnotassociated withage,sex,bodymassindex,durationofillness,ordailydoseofotherpsychotropicdrugs. Conclusion:Theseresultssuggestthatantipsychoticdrugsexertasignificantdose-dependenteffectontheextent ofdeclineinANSactivity,andthatoptimalantipsychoticmedicationisrequiredtoavoidpossiblecardiovascular adverseeventsinpatientswithschizophrenia. Keywords:Adversedrugeffect,Antipsychoticdrug,Autonomicnervoussystem,Heartratevariability,Schizophrenia Background factorforautonomic