Neuropsychiatric consequences of cardiovascular medications
- PMID: 17506224
- PMCID: PMC3181843
- DOI: 10.31887/DCNS.2007.9.1/jchuffman
Neuropsychiatric consequences of cardiovascular medications
Abstract
The use of cardiovascular medications can have a variety of neuropsychiatric consequences. Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs. Depression has been associated with P3-blockers, methyldopa, and reserpine, but more recent syntheses of the data have suggested that these associations are much weaker than originally believed. Though low cholesterol levels have been associated with depression and suicide, lipid-lowering agents have not been associated with these adverse effects. Finally, cardiovascular medications may have beneficial neuropsychiatric consequences; for example, the use of clonidine in patients with attention deficit-hyperactivity disorder, the use of prazosin for patients with post-traumatic stress disorder; and the use of propranolol for performance anxiety and akathisia.
El empleo de medicamentos cardiovasculares puede tener una variedad de consecuencias neuropsiquiátricas. Muchos fármacos cardiovasculares provocan con mayor frecuencia fatiga y sedación respecto del placebo y también existen muchos reportes de casos de síntomas afectivos, psicosis y trastornos cognitivos inducidos por varios de estos medicamentos. Se ha asociado la depresión con beta-bloqueadores, metildopa y reserpina, pero análisis recientes de estos datos han sugerido que estas asociaciones son mucho más débiles que lo que originalmente se pensaba. Aunque los niveles reducidos de colesterol se han asociado con depresión y suicidio, los fármacos reductores de lípidos no se han asociado con estos efectos adversos. Por último, los fármacos cardiovasculares pueden tener efectos neuropsiquiátricos útiles; por ejemplo, el empleo de clonidina en pacientes con trastorno por déficit atencionaI con hiperactividad, el uso de prazosin en pacientes con trastorno por estrés postraumático y la indicación de propranolol en la ansiedad de rendimiento y en la acatisia.
Les traitements cardiovasculaires peuvent avoir des conséquences neuropsychiatriques variées. De nombreux produits cardiovasculaires induisent une fatigue et une sédation plus importantes que le placebo. Des troubles cognitifs, de l'humeur et psychotiques ont été considérés comme provoqués par un grand nombre de ces traitements cardiotropes. La dépression a parfois été associée aux β-bloquants, à la méthyldopa et à la réserpine, mais des données plus récentes laissent penser que ces associations sont beaucoup moins importantes qu'initialement pressenties. Bien que des cholestérolémies basses aient été associées à la dépression et au suicide, les hypolipémiants n'ont pas été incriminés dans de tels effets indésirables. Les traitements cardiovasculaires peuvent finalement avoir des conséquences neuropsychiatriques bénéfiques : par exemple, l'utilisation de la clonidine chez les patients atteints d'un déficit de l'attention/hyperactivité, l'utilisation de la prazosine pour ceux souffrant d'un syndrome de stress post-traumatique, et l'utilisation du propranolol pour l'anxiété de performance (trac) et l'akathisie.
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