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 Diagnostic and Statistical Manual (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