Cardiac Risks in Patients Using Antipsychotics

The use of the antipsychotic drugs quetiapine and haloperidolis associated with an increased risk of ventricular arrhythmias and sudden cardiac death (SCD) caused by drug-induced QT prolongation, reports a new study in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier. 

Caution is advised to manage cardiac risks in patients prescribed these medications, the authors of the study and an accompanying editorial say.

The risks of cardiac conditions associated with the use of antipsychotics have been a concern for the last 30 years. Drugs have previously been either removed from the market or had their use restricted due to an unacceptably high risk of lethal ventricular arrhythmias.

The research involved a retrospective analysis of electronic medical records of a large cohort of patients from a healthcare provider in Taiwan who received quetiapine or haloperidol therapy. Investigators evaluated the incidences, risk factors, and clinical correlates of severe QT prolongation (i.e., ventricular arrhythmias and sudden cardiac death) in these patients.

The most significant results of the study were that more than 10% of patients developed severe QT prolongation during follow-up and the increased risk of ventricular arrhythmias and sudden cardiac death in quetiapine or haloperidol users who developed severe QT prolongation.

Co-author Chun-Li Wang, MD, of the Cardiovascular Division, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, says the findings underscore the importance of closely monitoring patients receiving these medications and implementing appropriate risk mitigation strategies to ensure patient safety.

“Clinicians should be aware of the potential risks associated with quetiapine use, particularly the risk of severe QT prolongation and its associated outcomes, including ventricular arrhythmias and sudden cardiac death.”

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Sources:

Chun-Li Wang, Victor Chien-Chia Wu, Cheng Hung Lee, Chia-Ling Wu, Hui-Ming Chen, Yu-Tung Huang, Shang-Hung Chang. Incidences, risk factors, and clinical correlates of severe QT prolongation after the use of quetiapine or haloperidol. Heart Rhythm, 2024; DOI: 10.1016/j.hrthm.2023.10.027

Clifford TeBay, Jamie I. Vandenberg. The real-world incidence of severe QT prolongation in patients taking antipsychotic drugs. Heart Rhythm, 2024; DOI: 10.1016/j.hrthm.2023.11.012

Elsevier. (2024, January 15). Vigilant monitoring is needed to manage cardiac risks in patients using antipsychotics, doctors say. ScienceDaily. Retrieved January 15, 2024 from www.sciencedaily.com/releases/2024/01/240115121220.htm

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