QTc prolongation and antipsychotic medications in a sample of 1017 patients with schizophrenia

Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics

“…Also, our study showed that female patients had a higher prevalence of QTc prolongation, as well as longer QTc intervals than male patients, which is consistent with previous studies (Vieweg 2002;Lin et al 2004;Sumić et al 2007;Ramos-Ríos et al 2010). However, some studies reported no sex difference in QTc prolongation (Ozeki et al 2010). Other studies failed to detect female gender as a significant risk factor (Reilly et al 2000;Chong et al 2003;Rettenbacher et al 2005), or even QTc prolongation was found more commonly in male patients than in female patients (Ozeki et al 2010).…”

“…First, despite the large size and wide heterogeneity of our sample, we could not detect the effects of some of the more problematic antipsychotics such as thioridazine, sertindole, ziprasidone, and intravenous haloperidol (Czekalla et al 2001;Harrigan et al 2004;Taylor 2003;Ozeki et al 2010). Thus, we could not confirm the effect of these drugs.…”

“…However, some studies reported no sex difference in QTc prolongation (Ozeki et al 2010). Other studies failed to detect female gender as a significant risk factor (Reilly et al 2000;Chong et al 2003;Rettenbacher et al 2005), or even QTc prolongation was found more commonly in male patients than in female patients (Ozeki et al 2010). Female gender is known to be a risk factor for QTc prolongation (Taylor 2003;Vieweg et al 2009).…”

“…The mean QTc interval change was greatest in the thioridazine group, following by ziprasidone, haloperidol, quetiapine, risperidone, and olanzapine. A most recent study crosssectionally examined the risk of QTc prolongation of antipsychotic drugs in a large clinical sample from Japan, showing that chlorpromazine, intravenous haloperidol, and sultopride were associated with an increased risk of QTc prolongation, whereas the second-generation antipsychotic drugs (i.e., olanzapine, quetiapine, risperidone, and zotepine), mood stabilizers, benzodiazepines, and antiparkinsonian drugs did not prolong the QTc interval (Ozeki et al 2010). However, another recent cross-sectional study found that only 10 patients (6%) had a prolonged QTc interval in all inpatients (n=171) in a Spanish long-term psychiatric hospital.…”

Safety and Tolerability of Antipsychotics

“…Cardiac arrhythmias were detected in 4,794 cases, and three agents with the highest ROR are amisulpride, cyamemazine, and olanzapine. The olanzapine fi nding was surprising as other pharmacovigilance studies were not able to separate this agent from other SGAs in association with prolonged QTc intervals, TdP, or cardiac arrhythmias (Manu et al 2011 ;Ozeki et al 2010 ). The risk of sudden cardiac death and antipsychotics in a Medicaid and dual eligible Medicare-Medicaid population of 459,614 patients from fi ve different states reported that haloperidol and chlorpromazine had less favorable profi les.…”