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Sala M, Vicentini A, Brambilla P, et al. QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Ann Gen Psychiatry. 2005;4(1):1doi: 10.1186/1744-859X-4-1.
Sala, M., Vicentini, A., Brambilla, P., Montomoli, C., Jogia, J. R., Caverzasi, E., Bonzano, A., Piccinelli, M., Barale, F., & De Ferrari, G. M. (2005). QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Annals of general psychiatry, 4(1), 1. https://doi.org/10.1186/1744-859X-4-1
Sala, Michela, et al. "QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy." Annals of general psychiatry vol. 4,1 (2005): 1. doi: https://doi.org/10.1186/1744-859X-4-1
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 Jan 25;4(1):1. doi: 10.1186/1744-859X-4-1. PMID: 15845138; PMCID: PMC1088007.
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Ann Gen Psychiatry. 2005 Jan 25;4(1):1. doi: 10.1186/1744-859X-4-1.

QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy.

Annals of general psychiatry

Michela Sala, Alessandro Vicentini, Paolo Brambilla, Cristina Montomoli, Jigar Rs Jogia, Eduardo Caverzasi, Alberto Bonzano, Marco Piccinelli, Francesco Barale, Gaetano M De Ferrari

Affiliations

  1. Department of Health Sciences-Section of Psychiatry, IRCCS Policlinico S, Matteo, University of Pavia, School of Medicine, Pavia, Italy. [email protected].

PMID: 15845138 PMCID: PMC1088007 DOI: 10.1186/1744-859X-4-1

Abstract

BACKGROUND: Several antipsychotic agents are known to prolong the QT interval in a dose dependent manner. Corrected QT interval (QTc) exceeding a threshold value of 450 ms may be associated with an increased risk of life threatening arrhythmias. Antipsychotic agents are often given in combination with other psychotropic drugs, such as antidepressants, that may also contribute to QT prolongation. This observational study compares the effects observed on QT interval between antipsychotic monotherapy and psychoactive polytherapy, which included an additional antidepressant or lithium treatment. METHOD: We examined two groups of hospitalized women with Schizophrenia, Bipolar Disorder and Schizoaffective Disorder in a naturalistic setting. Group 1 was composed of nineteen hospitalized women treated with antipsychotic monotherapy (either haloperidol, olanzapine, risperidone or clozapine) and Group 2 was composed of nineteen hospitalized women treated with an antipsychotic (either haloperidol, olanzapine, risperidone or quetiapine) with an additional antidepressant (citalopram, escitalopram, sertraline, paroxetine, fluvoxamine, mirtazapine, venlafaxine or clomipramine) or lithium. An Electrocardiogram (ECG) was carried out before the beginning of the treatment for both groups and at a second time after four days of therapy at full dosage, when blood was also drawn for determination of serum levels of the antipsychotic.Statistical analysis included repeated measures ANOVA, Fisher Exact Test and Indipendent T Test. RESULTS: Mean QTc intervals significantly increased in Group 2 (24 +/- 21 ms) however this was not the case in Group 1 (-1 +/- 30 ms) (Repeated measures ANOVA p < 0,01). Furthermore we found a significant difference in the number of patients who exceeded the threshold of borderline QTc interval value (450 ms) between the two groups, with seven patients in Group 2 (38%) compared to one patient in Group 1 (7%) (Fisher Exact Text, p < 0,05). CONCLUSIONS: No significant prolongation of the QT interval was found following monotherapy with an antipsychotic agent, while combination of these drugs with antidepressants caused a significant QT prolongation. Careful monitoring of the QT interval is suggested in patients taking a combined treatment of antipsychotic and antidepressant agents.

References

  1. Drugs. 2002;62(11):1649-71 - PubMed
  2. Psychol Med. 2002 Feb;32(2):227-37 - PubMed
  3. Lancet. 2000 Mar 25;355(9209):1048-52 - PubMed
  4. J Pharmacol Exp Ther. 2002 Feb;300(2):543-8 - PubMed
  5. Br J Pharmacol. 2003 Jul;139(5):883-4 - PubMed
  6. J Clin Psychiatry. 2001;62 Suppl 2:35-40 - PubMed
  7. FEBS Lett. 2002 Feb 13;512(1-3):59-66 - PubMed
  8. Lancet. 2000 May 20;355(9217):1824-5 - PubMed
  9. Fundam Clin Pharmacol. 2004 Apr;18(2):139-51 - PubMed
  10. J Clin Psychiatry. 2002;63 Suppl 9:12-7 - PubMed
  11. Br J Pharmacol. 1999 Sep;128(2):479-85 - PubMed
  12. J Clin Psychopharmacol. 2004 Feb;24(1):62-9 - PubMed
  13. J Clin Psychopharmacol. 2001 Feb;21(1):8-13 - PubMed
  14. Acta Psychiatr Scand. 2003 Feb;107(2):96-101 - PubMed
  15. Ther Drug Monit. 2001 Aug;23(4):435-40 - PubMed
  16. Pacing Clin Electrophysiol. 1998 May;21(5):1029-34 - PubMed
  17. Br J Psychiatry. 1998 Apr;172:331-6 - PubMed
  18. Lancet. 2000 May 20;355(9217):1825 - PubMed
  19. Eur J Pharmacol. 2002 Aug 16;450(1):37-41 - PubMed
  20. Soc Psychiatry Psychiatr Epidemiol. 2000 Aug;35(8):380-7 - PubMed
  21. Cardiovasc Res. 2000 Aug;47(2):219-33 - PubMed
  22. Psychiatry Res. 2000 Jul 17;94(3):279-85 - PubMed
  23. Naunyn Schmiedebergs Arch Pharmacol. 2002 Oct;366(4):350-6 - PubMed
  24. Br J Pharmacol. 2003 Jul;139(5):887-98 - PubMed
  25. Cardiovasc Res. 2003 Apr 1;58(1):32-45 - PubMed

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