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http://dx.doi.org/10.22722/KJPM.2021.29.1.11

Clinical Correlates of QTc Prolongation in Patients with Schizophrenia : A Retrospective Study  

Lee, Jung Suk (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
Park, Jaesub (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
Park, Sunyoung (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
Publication Information
Korean Journal of Psychosomatic Medicine / v.29, no.1, 2021 , pp. 11-16 More about this Journal
Abstract
Objectives : QTc prolongation due to antipsychotics is of major concern because it may lead to fatal ventricular arrhythmia such as torsade de pointes. However, few studies have been conducted on QTc prolongation due to antipsychotics, especially in South Korea. This study aimed to investigate how demographic and clinical variables affect QTc interval in patients with schizophrenia. Methods : By retrospectively reviewing medical records, we assessed QTc interval, demographic data and clinical features of 441 (175 males) patients with schizophrenia who admitted to the psychiatric ward of a general hospital. To explore the predictive factors for QTc interval, hierarchical regression analysis was performed with QTc interval as the dependent variable. Results : The mean QTc interval was 417.2±28.4 ms. In the hierarchical regression analysis, the use of short-acting antipsychotic injection was the strongest predictor of the QTc prolongation. Conclusions : This study demonstrated that the use of short-acting antipsychotic injection may affect QTc prolongation in patients with schizophrenia. This result suggests that more attention should be paid to the use of short-acting antipsychotic injection in the treatment of schizophrenia.
Keywords
QTc prolongation; Antipsychotics; Short-acting injection; Schizophrenia;
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1 Yang FD, Wang XQ, Liu XP, Zhao KX, Fu WH, Hao XR, Zhang XL, Huang GS, Qu SC, Bai JS, Huang XF, Kosten TR, Zhang XY. Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics. Psychopharmacology (Berl) 2011;216:9-16.   DOI
2 Beach SR, Celano CM, Sugrue AM, Adams C, Ackerman MJ, Noseworthy PA, Huffman JC. QT prolongation, torsades de pointes, and psychotropic medications: a 5-year update. Psychosomatics 2018;59:105-122.   DOI
3 Vieweg WV. New generation antipsychotic drugs and QTc interval prolongation. Prim Care Companion J Clin Psychiatry 2003;5:205-215.   DOI
4 Inada T, Inagaki A. Psychotropic dose equivalence in Japan. Psychiatry Clin Neurosci 2015;69:440-447.   DOI
5 Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, Samara M, Barbui C, Engel RR, Geddes JR, Kissling W, Stapf MP, Lassig B, Salanti G, Davis JM. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 2013;382:951-962.   DOI
6 Stollberger C, Huber JO, Finsterer J. Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol 2005;20:243-251.   DOI
7 Vandael E, Vandenberk B, Vandenberghe J, Willems R, Foulon V. Risk factors for QTc-prolongation: systematic review of the evidence. Int J Clin Pharm 2017;39:16-25.   DOI
8 Takeuchi H, Suzuki T, Remington G, Uchida H. Antipsychotic polypharmacy and corrected QT interval: a systematic review. Can J Psychiatry 2015;60:215-222.   DOI
9 Sala M, Vicentini A, Brambilla P, Montomoli C, Jogia JR, Caverzasi E, Bonzano A, Piccinelli M, Barale F, De Ferrari GM. QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Ann Gen Psychiatry 2005;4:1.   DOI
10 Harvey AT, Flockhart D, Gorski JC, Greenblatt DJ, Burke M, Werder S, Preskorn SH. Intramuscular haloperidol or lorazepam and QT intervals in schizophrenia. J Clin Pharmacol 2004;44:1173-1184.   DOI
11 Miceli JJ, Tensfeldt TG, Shiovitz T, Anziano R, O'Gorman C, Harrigan RH. Effects of Oral Ziprasidone and Oral Haloperidol on QTc interval in patients with Schizophrenia or Schizoaffective disorder. Pharmacotherapy 2010;30:127-135.   DOI
12 Miceli JJ, Tensfeldt TG, Shiovitz T, Anziano RJ, O'Gorman C, Harrigan RH. Effects of high-dose ziprasidone and haloperidol on the QTc interval after intramuscular administration: a randomized, single-blind, parallel-group study in patients with schizophrenia or schizoaffective disorder. Clin Ther 2010;32:472-491.   DOI
13 Lin CH, Chen MC, Wang SY, Lin CY. Predictive factors for QTc prolongation in schizophrenic patients taking antipsychotics. J Formos Med Assoc 2004;103:437-441.
14 Cahoon WDJ. Acquired QT prolongation. Prog Cardiovasc Nurs 2009;24:30-33.   DOI
15 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington, DC: American Psychiatric Association;2000.
16 Algra A, Tijssen JG, Roelandt JR, Pool J, Lubsen J. QT interval variables from 24 hour electrocardiography and the two year risk of sudden death. Br Heart J 1993;70:43-48.   DOI
17 Park SC, Lee MS, Kang SG, Lee SH. Patterns of antipsychotic prescription to patients with schizophrenia in Korea: results from the health insurance review & assessment servicenational patient sample. J Korean Med Sci 2014;29:719-728.   DOI