Haloperidol-Induced Torsades de Pointes

Cardiac side effects of psychiatric drugs

“…Other reports have described QT interval prolongation following treatment with chlorpromazine and haloperidol taken at doses exceeding 20 mg per day (Kriwisky et al, 1990). Data regarding the other typical agents are inconclusive, although several other studies have reported QT interval prolongation in patients receiving a variety of typical agents, even at conventional doses (Kitayama et al, 1999;Warner et al, 1996).…”

Torsades de pointes secondary to intravenous haloperidol after coronary bypass grafting surgery

“…2-10 Initially described during haloperidol overdoses, 2 torsades de pointes appeared following conventional doses of haloperidol . 3,4 Wilt et al observed this type of arrhythmia in four women who received large doses of intravenous haloperidol. 5 In Kay's series of 32 patients and Di Salva's, torsades de pointes occurred mostly in patients with underlying heart disease, 6,7 most frequently ischemic heart disease, in 53% of patients in some series 6 but it is also described in patients with liver diseases 8,9 and in critically ill patients.…”

Dr. Hamann and Colleagues Reply

“…11 PSYCHIATRIST.COM Haloperidol was introduced in 1958, and to date, this antipsychotic drug is frequently prescribed not only by psychiatrists but also in medicine and surgery to induce sedation. Haloperidol has been observed to predispose to QT prolongation and torsades de pointes, [12][13][14] even though recent studies demonstrated its therapeutic safety. 15,16 Haloperidol and its reduced form are substrates of CYP3A4 and inhibitors of CYP2D6, thus pharmacokinetic interactions may occur between haloperidol and other drugs given concomitantly, e.g., aripiprazole.…”