Key result
Amisulpride and clozapine linked to strongest antipsychotic cardiotoxicity, with amisulpride carrying ~9-fold greater QT prolongation risk.
Why the study?
This study aimed to investigate the characteristics and spectrum of cardiotoxicity induced by various antipsychotics using real-world pharmacovigilance data.
Do various antipsychotics increase the risk of cardiotoxicity adverse events in patients reported in the FAERS database?
Observational (n=2,361,487)
Do various antipsychotics increase the risk of cardiotoxicity adverse events in patients reported in the FAERS database?
Answers are grounded in this paper and cite their sources.
Antipsychotics, particularly clozapine and amisulpride, are associated with significant cardiotoxicity including cardiomyopathy and QT prolongation, highlighting the need for cardiac monitoring.
Objective: This study aimed to investigate the characteristics and spectrum of cardiotoxicity induced by various antipsychotics based on the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database. Methods: Data of the FAERS database from the first quarter of 2015 to the fourth quarter of 2020 were downloaded for disproportionality analysis. The significant signal was evaluated by reporting odds ratios and information components with statistical shrinkage transformation. Results: A total of 2,361,487 records were extracted for disproportionality analysis. Among the 10 antipsychotics, clozapine and amisulpride performed strong cardiotoxicity. Cardiomyopathy, cardiac arrhythmia, and Torsade de pointes/QT prolongation were the common cardiac adverse event induced by antipsychotics. Different characteristics of the spectrum of cardiotoxicity in various APs were discovered after further data mining. Moreover, evidence of the association between antipsychotics and eosinophilic myocarditis, peripartum cardiomyopathy was provided in this study. Conclusion: Antipsychotics presented cardiotoxicity in different degrees, and more cardiac examinations should be monitored in patients with antipsychotics.
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He et al. (2022) conducted an observational in Adverse events associated with antipsychotic use (n=2,361,487). Antipsychotics (e.g., amisulpride, clozapine) vs. Non-cases (reports with other Standardized MedDRA Queries) was evaluated on Torsade de pointes/QT prolongation (amisulpride) (ROR 8.749, 95% CI 8.561-8.940). Among 10 antipsychotics evaluated in the FAERS database, amisulpride and clozapine demonstrated the strongest cardiotoxicity signals, including a high risk of Torsade de pointes/QT prolongation with amisulpride.
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