title: Psychotropic drugs and ventricular repolarisation: The effects on QT interval, T-peak to T-end interval and QT dispersion.
abstract: We aimed to investigate in a clinical setting, the effects of different classes of psychotropic drugs on cardiac electrophysiological measures linked with an increased risk of sudden cardiac death.
  
  
  
  We conducted a cross-sectional study in a population of 1059 psychiatric inpatients studying the effects of various psychotropic drugs on the T-peak to T-end (TpTe) interval, QT dispersion and QT interval.
  
  
  
  Methadone use showed a strong association with TpTe prolongation (odds ratio (OR)=12.66 (95% confidence interval (CI), 3.9-41.1), p<0.001), an effect independent from action on QT interval. Mood stabilisers showed significant effects on ventricular repolarisation: lithium was associated with a TpTe prolongation (OR=2.12 (95% CI, 1.12-4), p=0.02), while valproic acid with a TpTe reduction (OR=0.6 (95% CI, 0.37-0.98), p=0.04). Among antipsychotics, clozapine increased TpTe (OR=9.5 (95% CI, 2.24-40.39), p=0.002) and piperazine phenothiazines increased QT dispersion (OR=2.73 (95% CI, 1.06-7.02), p=0.037).
  
  
  
  Treatment with psychotropic drugs influences TpTe and QT dispersion. These parameters might be considered to better estimate the sudden cardiac death risk related to specific medications. Beyond antipsychotics and antidepressants, mood stabilisers determine significant effects on ventricular repolarisation.
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Acciavatti
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Corbo
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cinosi
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lupi
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ricci
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Di Scala
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: D'Ugo
authors.affiliation: 2 Department of Cardiology, European Hospital, Rome, Italy.
authors.forename: Viola
authors.initials: V
authors.lastname: De Francesco
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.affiliation: 1 Departement of Neuroscience and Imaging, University G. d'Annunzio, Chieti, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: di Giannantonio
mesh_terms: D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012306:Risk
chemical_list: D011619:Psychotropic Drugs; D008691:Methadone
keywords: QT dispersion; QT interval; Sudden cardiac death; T-peak to T-end; repolarisation; ventricular