Key result
Treatment with TCAs and psychotropic polytherapy was associated with significantly shorter RR intervals compared to no TCAs and monotherapy (p < 0.05) among adult outpatients.
Why the study?
Electrocardiographic changes produced by antipsychotics and other psychotropic medications have mostly been evaluated for QTc interval prolongation, leaving other interval changes less understood.
Do antipsychotics and other psychotropic medications alter ECG intervals beyond QTc in adult outpatients?
Cross-Sectional
Do antipsychotics and other psychotropic medications alter ECG intervals beyond QTc in adult outpatients?
p-value: p=<0.05
Psychotropic medications, particularly TCAs and polytherapy, are associated with significant ECG changes beyond QTc prolongation, such as shortened RR intervals and age-correlated PR prolongation.
May prompt ECG monitoring with TCAs or polytherapy; hypothesis-generating observational data requiring prospective confirmation.
The ECG changes produced by antipsychotics and other psychotropic medications are studied mostly regarding QTc interval prolongation. This study aimed to investigate ECG changes beyond long QTc interval produced by psychotropic medications. A cross-sectional study was conducted to assess the effect of these agents on RR, PR, TpTe intervals and TpTe/QT ratio among Jordanian outpatients. The RR interval was significantly shorter among patients on TCAs versus those not receiving TCAs and among patients on polytherapy versus those on monotherapy (p < 0.05 for both comparisons), when adjusted for age, gender, BMI, caffeine intake, smoking, presence of diabetes mellitus, cardiovascular disease and medications known to produce heart rate changes. Positive correlations were found between the PR interval and age in patients treated with SGAs, SSRIs, citalopram, polytherapy and in the total sample (p < 0.01 for all). Inverse correlations were found between the RR interval and the number of psychotropic medications among patients treated with SSRIs and in the whole study sample (p < 0.01 for both). In conclusion, various ECG changes beyond QTc interval prolongation are observed in patients on antipsychotics and other psychotropic medications, in those on polytherapy. It is recommended to obtain an ECG before starting patients on psychotropic drugs known to produce electrocardiographic changes and their combinations.
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Bulatova et al. (2022) conducted a cross-sectional in Outpatients on psychotropic medications. Antipsychotics and other psychotropic medications (including TCAs and polytherapy) vs. Patients not receiving specific psychotropic medications or on monotherapy was evaluated on RR, PR, TpTe intervals and TpTe/QT ratio (p=<0.05). Treatment with TCAs and psychotropic polytherapy was associated with significantly shorter RR intervals compared to no TCAs and monotherapy (p < 0.05) among adult outpatients.
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