Analysis of the QTc Interval During Olanzapine Treatment of Patients With Schizophrenia and Related Psychosis

Czekalla, J.; Beasley, Charles M.; Dellva, Mary Anne; Berg, Paul H.; Grundy, Starr

doi:10.4088/jcp.v62n0310

Cited by 115 publications

(44 citation statements)

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“…Sertindole has a clear association with QT prolongation (Agelink et al, 2001), and there appears to be a dose-related effect of risperidone (Tran et al, 1997) and clozapine (Kang et al, 2000). Olanzapine (Czekalla et al, 2001) and quetiapine (Small et al, 1997) appear not to have significant effects on cardiac electrophysiology in clinical studies, and data for amisulpiride are too few to draw any meaningful conclusions. In animals, however, there is evidence that haloperidol, clozapine, olanzapine, risperidone and sertindole cause QT prolongation that is concentration related (Drici et al, 1998).…”

Section: Drug-induced Qt Prolongationmentioning

confidence: 99%

Cardiac side effects of psychiatric drugs

Mackin

2007

Hum. Psychopharmacol. Clin. Exp.

142

117

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Section: Drug-induced Qt Prolongationmentioning

confidence: 99%

Cardiac side effects of psychiatric drugs

Mackin

2007

Hum. Psychopharmacol. Clin. Exp.

142

117

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“…The new atypical antipsychotics have greater efficacy and fewer side effects than older neuroleptics and with the exceptions of sertindole and ziprasidone they have not caused consistent statistically significant lengthening of QT or sudden cardiac death at therapeutic concentrations [ 118,133 ]. Sertindole has been proven to be associated with a QT prolongation at therapeutic concentrations [ 117,124 ], and both increasing evidence of unexplained sudden cardiac death and serious arrhythmias found by the Committee on Safety of Medicine in the United Kingdom resulted in a voluntary withdrawal of the drug by the manufacturer [ 134 ].…”

Section: Clinical Evidencementioning

confidence: 99%

Cardiovascular Side Effects of New Antidepressants and Antipsychotics: New Drugs, old Concerns?

Pacher¹,

Kecskeméti

2004

CPD

346

218

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The cardiovascular toxicity of older generation of tricyclic antidepressants (e.g. imipramine, desipramine, amitriptyline, clomipramine) and neuroleptics (e.g. haloperidol, droperidol, thioridazine, pimozide) is well established. These drugs inhibit cardiovascular Na + , Ca 2+ and K + channels often leading to life-threatening arrhythmia.To overcome the toxicity of old generation of antidepressants and antipsychotics, selective serotonin reuptake inhibitor antidepressants (SSRIs: fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, venlafaxin) and several new antipsychotics (e.g. clozapine, olanzapine, risperidone, sertindole, aripiprazole, ziprasidone, quetiapine) were introduced during the past decade. Although these new compounds are not more effective in treating psychiatric disorders than older medications, they gained incredible popularity since they have been reported to have fewer and more benign side effect profile (including cardiovascular) than predecessors.Surprisingly, an increasing number of case reports have demonstrated that the use of SSRIs and new antipsychotics (e.g. clozapine, olanzapine, risperidone, sertindole, aripiprazole, ziprasidone, quetiapine) is associated with cases of arrhythmias, prolonged QTc interval on electrocardiogram (ECG) and orthostatic hypotension in patients lacking cardiovascular disorders, raising new concerns about the putative cardiovascular safety of these compounds. In agreement with these clinical reports these new compounds indeed show marked cardiovascular depressant effects in different mammalian and human cardiovascular preparations by inhibiting cardiac and vascular Na + , Ca 2+ and K + channels. Taken together, these results suggest that the new generation of antidepressants and antipsychotics also have clinically important cardiac as well as vascular effects. Clinicians should be more vigilant about these potential adverse reactions and ECG control may be suggested during therapy, especially in patients with cardiovascular disorders.The primary goal of this review is to shed light on the recently observed clinically important cardiovascular effects of new antidepressants and antipsychotics and discuss the mechanism beyond this phenomenon.

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“…Data extraction sheets for these studies can be found in appendix 4. Two related to weight change, 194,195 six to mortality (of which two were in the manufacturer's submission and two in the sertindole submission), [196][197][198] one to cardiac conductivity, 199 and one to tardive dyskinesia. 200 …”

Section: Rare or Long-term Eventsmentioning

confidence: 99%

“…In a study that presented ECG recordings from four RCTs (Czekella 2001 199 ), Q-Tc readings from olanzapine-treated patients were compared with placebo-, haloperidol-and risperidone-treated patients; olanzapine did not contribute to prolonged Q-Tc.…”

Section: Cardiac Conductivitymentioning

confidence: 99%

A systematic review of atypical antipsychotic drugs in schizophrenia

Bagnall

Jones

Ginnelly

et al. 2003

Health Technol Assess

151

114

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Analysis of the QTc Interval During Olanzapine Treatment of Patients With Schizophrenia and Related Psychosis

Cited by 115 publications

References 0 publications

Cardiac side effects of psychiatric drugs

Cardiac side effects of psychiatric drugs

Cardiovascular Side Effects of New Antidepressants and Antipsychotics: New Drugs, old Concerns?

A systematic review of atypical antipsychotic drugs in schizophrenia

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