TABLE 2.

Key Points Summarizing the Current Knowledge of Psychiatric Illness in TC

Key points
There is a strong association between psychiatric illness and TC.
The pathophysiology behind this association is largely speculative. Postulated mechanisms include the role of the brain-heart axis and catecholamine excess in patients with psychiatric illness.
The spectrum of psychiatric illness associated with TC likely includes both anxiety and mood spectrum disorders. The association of other psychiatric illnesses, including psychoses, with TC remains largely unknown.
In patients with psychiatric illness, TC may be triggered by physical or emotional stress.
There are reports linking uptitration or overdose of SNRIs and S-NRIs with triggering of TC. The long-term safety profiles and ideal choice of psychotropic agents in patients with TC is poorly delineated.
ECT has been extensively reported as a potential trigger of TC and should be used with caution in patients with a history of TC.
Pre-existing psychiatric illness may be associated with increased recurrence of TC; however, other long-term prognostic implications are unknown.
Further studies are needed to better evaluate the management of psychiatric illness in TC, with a focus on the role and safety profile of pharmacotherapy and ECT.