Assessing Cardiovascular Risks Versus Clinical Benefits of Atypical Antipsychotic Drug Treatment

The atypical antipsychotic drugs are a major advance in the treatment of psychosis in spite of concernsabout metabolic and cardiovascular side effects that affect morbidity and mortality. Concernsabout weight gain, hypoglycemia, diabetes, and increases in lipids as well as sudden death due totorsades de pointes and other cardiovascular events can temper enthusiasm about the atypical antipsychotics.The challenge for the clinician is to weigh the benefits and risks for each drug for each patientand develop a treatment plan with the individual patient in mind. This article discusses both risks andbenefits of antipsychotic treatment and presents a treatment algorithm to aid the clinician in choosingmedications for the psychotic patient.