First-generation antipsychotics and QTc: any role for mediating variables?

Carrà, Giuseppe; Crocamo, Cristina; Bartoli, Francesco; Lax, Annamaria; Tremolada, Martina; Lucii, Claudio; Martinotti, Giovanni; Nosè, Michela; Bighelli, Irene; Ostuzzi, Giovanni; Castellazzi, Mariasole; Clerici, Massimo; Barbui, Corrado

doi:10.1002/hup.2540

2016

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Title:: First-generation antipsychotics and QTc: any role for mediating variables?
Document type:: Journal Article
Author(s):: Carrà, Giuseppe; Crocamo, Cristina; Bartoli, Francesco; Lax, Annamaria; Tremolada, Martina; Lucii, Claudio; Martinotti, Giovanni; Nosè, Michela; Bighelli, Irene; Ostuzzi, Giovanni; Castellazzi, Mariasole; Clerici, Massimo; Barbui, Corrado
Abstract:: Corrected QT (QTc) interval prolongation is often associated with use of first-generation antipsychotics (FGAs). However, other factors require appropriate consideration, including age and gender, the role of other known medications associated with QTc prolongation, and severe comorbid conditions, such as co-occurring alcohol abuse/dependence. We aimed to study potential mediating roles of different, related, candidate variables on QTc.We capitalized on data from a large (N = 2366), cross-sectional, national survey, the STAR Network QTc study, using a representative sample of people taking FGAs, and recruited from mental health services across Italy.About one-third of the sample was treated with FGAs, and almost one-tenth of the subjects took a different, additional, drug known to cause QTc prolongation. Our findings confirmed that there is an impact from FGAs, age, gender, alcohol misuse, and concurrent risky drugs on QTc. However, comorbid alcohol abuse/dependence and concurrent risky drugs did not mediate the effect of FGAs on QTc.Our findings showed that FGAs, concurrent risky drugs, and alcohol use disorders prolonged QTc. FGAs had a direct effect on QTc, confirming the need for clinicians to monitor a risk that could lead to sudden unexplained death. Copyright © 2016 John Wiley & Sons, Ltd.
Journal title abbreviation:: Hum Psychopharmacol
Year:: 2016
Journal volume:: 31
Journal issue:: 4
Pages contribution:: 313-8
Language:: eng
Fulltext / DOI:: doi:10.1002/hup.2540
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/27245736
Print-ISSN:: 0885-6222
TUM Institution:: Klinik und Poliklinik für Psychiatrie und Psychotherapie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Psychiatrie und Psychotherapie (Prof. Priller)2016