An analysis of QTc prolongation with atypical antipsychotic medications and selective serotonin reuptake inhibitors using a large ECG record database.
BACKGROUND
This study evaluated the effects of atypical antipsychotic drugs and selective serotonin reuptake inhibitors (SSRIs) on the corrected QT (QTc) interval using a large database obtained from clinical settings. Additionally, the effects of factors including age on QTc intervals were estimated.


METHODS
Using an open-access QT database (ECG-ViEW), QTc-lengthening effects of 14 selected atypical antipsychotics and SSRIs were compared to those of a positive control drug, cilostazol, and a negative control drug, diazepam. We also evaluated effects of age, sexgender, and select electrolyte levels on observed QTc intervals.


RESULTS
The frequency of QTc prolongation with the pooled data of the 14 study drugs was lower than that with cilostazol (age-adjusted odds ratio (OR) = 0.43, 95% confidence interval (CI) = 0.27-0.69), but no significant difference was found relative to when compared with that with diazepam (age-adjusted OR = 0.89, 95% CI = 0.55-1.47). Furthermore, administration of the 14 study drugs significantly increased the QTc interval by 2.89 ms after each 10-year age increment (p-value < 0.0001).


CONCLUSIONS
This study suggests that atypical antipsychotic drugs and SSRIs are less likely to be associated with QTc prolongation in clinical settings. In addition, age showed a significant association with the QTc interval. Further studies with well-characterized cohorts are warranted.
a Department of Clinical Pharmacology and Therapeutics , Seoul National University College of Medicine and Hospital , Seoul , Republic of Korea.
Sang-In
SI
Park
a Department of Clinical Pharmacology and Therapeutics , Seoul National University College of Medicine and Hospital , Seoul , Republic of Korea.
Hyungmi
H
An
a Department of Clinical Pharmacology and Therapeutics , Seoul National University College of Medicine and Hospital , Seoul , Republic of Korea.
Anhye
A
Kim
a Department of Clinical Pharmacology and Therapeutics , Seoul National University College of Medicine and Hospital , Seoul , Republic of Korea.
In-Jin
IJ
Jang
a Department of Clinical Pharmacology and Therapeutics , Seoul National University College of Medicine and Hospital , Seoul , Republic of Korea.
Kyung-Sang
KS
Yu
b Department of Clinical Pharmacology and Therapeutics , Seoul National University Bundang Hospital , Seongnam , Republic of Korea.
Jae-Yong
JY
Chung
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D000077407:Cilostazol; D016208:Databases, Factual; D003975:Diazepam / Q000009:adverse effects; D004562:Electrocardiography; D004573:Electrolytes / Q000378:metabolism; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D012737:Sex Factors; D013777:Tetrazoles / Q000009:adverse effects; D055815:Young Adult
D014150:Antipsychotic Agents; D000077407:Cilostazol; D003975:Diazepam; D004573:Electrolytes; D017367:Selective Serotonin Reuptake Inhibitors; D013777:Tetrazoles
Electrocardiogram; QTc interval; atypical antipsychotic drugs; selective serotonin reuptake inhibitors