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However, these agents may have heterogeneous properties, calling for an individualized approach based on efficacy and also on the particular side effect profile of each specific agent. Proarrhythmic effects arising from drug-induced long-QT syndrome and consequent potentially life-threatening polymorphic ventricular arrhythmias in the form of torsade de pointes, the metabolic syndrome contributing to atherosclerosis and acute coronary syndromes, and drug-induced orthostatic hypotension raise major concerns. Of course, it is also crucial that fear of potential CV adverse effects does not deprive psychiatric patients of appropriate drug therapy. Modification of CV risk factors in psychiatric patients together with optimal management of their CV diseases and appropriate selection of psychotropic agents with greater efficacy and least CV toxicity are of paramount importance in mitigating CV risks and enhancing safety. Identifying patients at high risk of CV complications and close monitoring of all patients receiving these agents are crucial steps to prevent and manage such complications. All these issues are herein reviewed, relevant guidelines are discussed, and schemas are depicted that illustrate the interrelated connections among the psychotropic agents and their CV effects.<\/jats:p>","DOI":"10.1177\/0003319718780145","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T23:32:16Z","timestamp":1528327936000},"page":"103-129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Cardiovascular Safety of Psychiatric Agents: A Cautionary Tale"],"prefix":"10.1177","volume":"70","author":[{"given":"Theodora A.","family":"Manolis","sequence":"first","affiliation":[{"name":"Zakynthos Hospital, Zakynthos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis A.","family":"Manolis","sequence":"additional","affiliation":[{"name":"Patras University School of Medicine, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-4745","authenticated-orcid":false,"given":"Antonis S.","family":"Manolis","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Athens University School of Medicine, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,6]]},"reference":[{"key":"bibr1-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15743"},{"key":"bibr2-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7507"},{"key":"bibr3-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1306-4"},{"key":"bibr4-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1159\/000284525"},{"issue":"5","key":"bibr5-0003319718780145","first-page":"768","volume":"16","author":"Shelton RC","year":"1994","journal-title":"Clin Ther"},{"issue":"5","key":"bibr6-0003319718780145","first-page":"2S","volume":"94","author":"Preskorn SH","year":"1993","journal-title":"Am J Med"},{"key":"bibr7-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2008.04.020"},{"key":"bibr8-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61764-X"},{"key":"bibr9-0003319718780145","doi-asserted-by":"publisher","DOI":"10.2174\/1381612043383872"},{"issue":"4","key":"bibr10-0003319718780145","first-page":"253","volume":"28","author":"Chue P","year":"2003","journal-title":"J Psychiatry Neurosci"},{"key":"bibr11-0003319718780145","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200317050-00002"},{"key":"bibr12-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1002\/hup.915"},{"key":"bibr13-0003319718780145","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.436"},{"key":"bibr14-0003319718780145","volume-title":"Lippincott Illustrated Reviews: Pharmacology","author":"Whalen K","year":"2015","edition":"6"},{"key":"bibr15-0003319718780145","unstructured":"American Psychiatric Association (APA): Diagnostic and Statistical Manual of mental disorders (DSM\u20135), Fifth Edition. 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