Role of Pharmacokinetics and Pharmacogenetics of Antidepressant-Induced Prolongation of the QT Interval and Torsade de Pointes in Patients with Mental Disorders

Abstract

Antidepressants (ADs) include drugs of various pharmacological groups, which are mainly used for the treatment of mental disorders (major depressive disorder, obsessive-compulsive disorder, social phobia, panic disorder, generalized anxiety disorder, post-traumatic stress disorder), chronic pain and addiction diseases. Chronic use of ADs can lead to the development of cardiotoxic adverse drug reactions (ADRs). The most important cardiotoxic AD-induced ADRs are prolongation of the QT interval, ventricular tachycardia of the "pirouette" type (Torsades de Pointes - TdP). This narrative review analyzes and summarizes the results of studies on pharmacokinecis and pharmacogenetics of ADs on QT interval prolongation and updates physicians' knowledge of the risk of developing AD-induced TdP in patients with psychiatric disorders.