Estimating and Reducing the Cardiovascular Risk of Patients With Schizophrenia Drugs From Lipid Measures and Ischemic Electrocardiographic Changes

Inclusion criteria To be eligible, a patient must : Be male or female, between 18-65. Have a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder according to DSM-IV criteria Have TG/HDL ratios (>>3.5) and ischemic EKG changes with and without clinical ischemia, e.g. angina Be treated for a minimum of six months with one of six oral antipsychotic medications: clozapine, haloperidol, olanzapine, quetiapine, risperidone and ziprasidone Be willing to change current antipsychotic medication to that chosen by the principal investigator Have a history of compliance with the above medication Be Medicaid eligible or maintain insurance covering requested lab procedures Be able to provide written informed consent. Exclusion criteria A patient will be considered ineligible if he/she: Has a diagnosis other than schizophrenia, schizoaffective disorder or bipolar disorder with psychotic features according to DSM-IV criteria. Has a history of noncompliance with prescribed psychiatric medications Has a TG/HDL ratio < 3.5 on current medication Is uninsured or is unable to self-pay potential costs of required lab procedures not covered by insurance. Is unable to provide written informed consent. (Females only) Is pregnant, lactating or plans to become pregnant during study participation