The Relationship Between Antipsychotic Drug Use and Electrocardiography Parameters

Abstract

Antipsychotic drugs have many known metabolic and cardiac effects. The aim of this study was to evaluate the relationship between electrocardiographic parameters and antipsychotic drug use in inpatients with psychotic disorder. For this purpose, electrocardiograms (ECG) of 200 psychotic patients who were hospitalized in our clinic were examined and the relationship between QTc interval, R-R distance and PR interval, the number of antipsychotic drugs used and the effect of antipsychotics on QTc were investigated. According to the data obtained, QTc intervals of the patients using multiple antipsychotic drugs were found to be significantly longer than those using monotherapy. When antipsychotic drugs were classified according to their potency on QTc, QTc intervals were found to be significantly longer in those receiving moderately effective drugs compared to lower effective drugs. In conclusion, considering the frequency of cardiovascular side effects in the follow-up and treatment of patients with psychotic disorder, multiple antipsychotic drugs use should be avoided as much as possible and drug selection should be given importance.

Keywords

• Antipsychotic drug,arrhythmia,electrocardiography (ECG),psychosis,QT interval

Antipsikotik İlaç Kullanımının Elektrokardiyografi Parametreleri ile İlişkisi

Öz

Antipsikotik ilaçların bilinen birçok metabolik ve kardiyak etkisi bulunmaktadır. Bu çalışmanın amacı yatarak tedavi görmüş psikotik bozukluk tanılı hastaların elektrokardiyografik parametreleri ile antipsikotik ilaç kullanımı arasındaki ilişkiyi değerlendirmektir. Bu amaçla kliniğimizde yatmış olan 200 psikotik bozukluk hastasının elektokardiyografileri (EKG) incelenerek, QTc aralığı, R-R mesafesi ve PR aralığı ile kullanılan antipsikotik ilaç sayısı ve antipsikotiklerin QTc üzerine etkisinin gücünün ilişkisi araştırılmıştır. Elde edilen verilere göre çoklu antipsikotik ilaç kullananların QTc aralıklarının monoterapi kullananlara göre anlamlı olarak daha uzun olduğu saptanmıştır. Antipsikotik ilaçlar QTc üzerine etki güçlerine göre sınıflandırıldığında, orta şiddette etkili ilaç alanların düşük etkili ilaç alanlara göre QTc aralıklarının anlamlı olarak daha uzun olduğu saptanmıştır. Sonuç olarak psikotik bozukluk tanılı hastaların takibi ve tedavisinde kardiyovasküler yan etki sıklığı dikkate alındığında, çoklu antipsikotik ilaç kullanımından mümkün oldukça kaçınılmalı ve ilaç seçimine önem verilmelidir.

Anahtar Kelimeler

• Antipsikotik,elektrokardiyogram,QT aralığı,aritmi,psikoz

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