Key result
Concomitant treatment with risperidone and electroconvulsive therapy did not significantly prolong the QTc interval compared to either treatment alone.
Why the study?
ECT and risperidone can each prolong the QTc interval and increase arrhythmia risk, but the effect of their concurrent administration on QTc was unknown.
Does the combination of risperidone and electroconvulsive therapy increase the QTc interval in psychiatric patients compared to either treatment alone?
Cross-Sectional (n=60)
No
Does the combination of risperidone and electroconvulsive therapy increase the QTc interval in psychiatric patients compared to either treatment alone?
Absolute Event Rate: 375.58% vs 386.17%
p-value: p=0.400
The combination of risperidone and electroconvulsive therapy does not significantly prolong the QTc interval in psychiatric patients, suggesting it is a safe therapeutic option regarding arrhythmia risk.
Concurrent risperidone-ECT effects on QTc remain uncertain; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Some types of antidepressants and antipsychotic medications have cardiovascular side effects that can be life-threatening. Electroconvulsive therapy (ECT) is capable of generating physiological stress and may lead to increased QT interval followed by arrhythmias. Risperidone can also increase the risk of arrhythmia by increasing the corrected QT (QTc) interval. Since many patients require co-administration of risperidone and ECT, this study aimed to investigate the concurrent effect of ECT and risperidone administration on the QTc interval. METHODS: For this cross-sectional study, 60 patients (18-65 years) admitted in 22 Bahman Psychiatric Hospital (Qazvin, Iran) that were candidate for treatment with risperidone, ECT, or both methods were concurrently divided into three groups. The groups included patients treated with ECT, risperidone, and combination treatment (risperidone and ECT). At the beginning of the study, electrocardiogram (ECG) was obtained for all patients and QT was performed manually, and finally, QTc interval was measured two times for each group. Required information was collected through medical records. Then, inferential statistics, analysis of variance (ANOVA), was used to determine differences between different variables. RESULTS: A significant increase in heart rate (HR) in the third group compared to first and second groups was observed. None of the treatments had a significant effect on QTc interval, but the QTc interval increased slightly in groups treated with the ECT alone and particularly, the ECT plus risperidone in comparison to the baseline values. CONCLUSION: Our study showed that risperidone, ECT, and their concomitant combination did not affect the QTc interval. Therefore, risperidone and ECT are safe and their combination can also be a good option for refractory patients undergoing ECG monitoring and cardiopulmonary devices.
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Rezaei et al. (2021) conducted a cross-sectional in Psychiatric disorders (Schizophrenia, Bipolar disorder, Major Depressive Disorder) (n=60). Electroconvulsive therapy and risperidone combination vs. Electroconvulsive therapy alone or risperidone alone was evaluated on Corrected QT (QTc) interval after treatment (p=0.400). Concomitant treatment with risperidone and electroconvulsive therapy did not significantly prolong the QTc interval compared to either treatment alone.
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