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No. 2 (2023)

PRACTICE

QT prolongation syndrome with Antipsychotic and Antidepressant Drugs

https://doi.org/10.21265/PSYPH.2023.69.57.006

Published 2023-06-30

  • D.I. Malin
    • ,
  • P.W. Ryvkin
    • ,
  • D.R. Bulatova

D.I. Malin
The Serbsky State Scientific Center for Social and Forensic Psychiatry

P.W. Ryvkin
Moscow Research Institute of Psychiatry – branch of the V.P. Serbian” of the Ministry of Health of the Russian Federation

D.R. Bulatova
Moscow Research Institute of Psychiatry – branch of the V.P. Serbian” of the Ministry of Health of the Russian Federation

Abstract

QT prolongation syndrome is a dangerous complication of psychopharmacotherapy and can cause the development of cardiac arrhythmia, leading to sudden death. The presented systematic literature review was performed based on a PubMed search for the keywords: drug-induced QT prolongation syndrome, cardiovascular side effects, cardiac arrhythmia, sudden death and antipsychotics or antidepressants. First-generation antipsychotics and especially thioridazine cause prolongation of the QT interval to the greatest extent. Of the second-generation antipsychotics, sertindole and ziprasidone have the greatest effect. Among antidepressants, the tricyclic antidepressants, citalopram and escitalopram, cause the most prolongation of the QT interval. Risk factors for the development of long QT syndrome in the use of antipsychotics and antidepressants have been identified. When prescribing psychotropic drugs that can cause a prolongation of the QT interval, it is necessary to follow certain principles of therapy, including dynamic monitoring of the ECG and electrolyte balance. In case of an increase in the initial corrected QT interval of more than 30 ms or an absolute value exceeding 500 ms, a dose reduction or discontinuation of the drug should be considered.

Keywords

QT prolongation syndrome, antipsychotics and antidepressants, cardiac arrhythmia, sudden death

PDF (Русский)

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