{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:46:01Z","timestamp":1780879561550,"version":"3.54.1"},"reference-count":84,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Heart failure (HF) is a leading cause of morbidity and mortality worldwide, and its co-occurrence with psychiatric disorders poses significant therapeutic challenges. This narrative review examines the safe use of psychopharmacological agents in patients with HF, focusing on mood stabilizers (particularly lithium) and antipsychotics. We summarize clinically relevant pharmacokinetic and pharmacodynamic interactions between these agents and guideline-directed HF therapies, including ACEIs, ARBs, ARNIs, beta-blockers, MRAs, SGLT2 inhibitors, and diuretics. Lithium is particularly prone to interactions due to its narrow therapeutic index and dependence on renal sodium handling, with RAAS inhibitors, thiazide diuretics, and SGLT2 inhibitors increasing the risk of toxicity. Antipsychotics are associated with QT prolongation, orthostatic hypotension, and electrolyte disturbances, with substantial variability between agents. This review highlights key clinical risks, provides a practical summary of drug interactions, and outlines principles for individualized, multidisciplinary management. Care requires coordinated cardiology\u2013psychiatry collaboration, careful drug selection, and assessment of renal function, electrolytes, drug levels, and ECG parameters. Further studies and improved guideline integration are needed.<\/jats:p>","DOI":"10.3390\/brainsci16050452","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:40:12Z","timestamp":1777981212000},"page":"452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychopharmacological Treatment in Patients with Heart Failure: A Narrative Review of Mood Stabilizers and Antipsychotics"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6166-4009","authenticated-orcid":false,"given":"B\u0142a\u017cej","family":"Pilarski","sequence":"first","affiliation":[{"name":"Doctoral School, Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie G\u00f3ry, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7526-1430","authenticated-orcid":false,"given":"Szymon","family":"Florek","sequence":"additional","affiliation":[{"name":"Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie G\u00f3ry, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Suchodolski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-7279","authenticated-orcid":false,"given":"Mariola","family":"Szulik","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Collegium Medicum, WSB University, 41-300 Dabrowa G\u00f3rnicza, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-0063","authenticated-orcid":false,"given":"Robert","family":"Pudlo","sequence":"additional","affiliation":[{"name":"Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie G\u00f3ry, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","first-page":"89","article-title":"Temporal trends and patterns in heart failure incidence: A population-based study of 4 million individuals","volume":"10","author":"Conrad","year":"2023","journal-title":"Eur. 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