1
|
The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients. Biomedicines 2022; 11:biomedicines11010013. [PMID: 36672524 PMCID: PMC9856039 DOI: 10.3390/biomedicines11010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
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.
Collapse
|
3
|
Garcia-Gonzalez MA, Vallejo-Ruiz V, Atonal-Flores F, Flores-Hernandez J, Torres-Ramírez O, Diaz-Fonsecae A, Perez Vizcaino F, Lopez-Lopez JG. Sildenafil prevents right ventricular hypertrophy and improves heart rate variability in rats with pulmonary hypertension secondary to experimental diabetes. Clin Exp Hypertens 2022; 44:355-365. [DOI: 10.1080/10641963.2022.2050743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Miguel Angel Garcia-Gonzalez
- Departamento de Farmacia, Benemerita Universidad Autonoma de Puebla, Laboratorio de Farmacia Clinica, Edificio FCQ10, Ciudad Universitaria, Col. Jardines de San Manuel, Puebla, Mexico
| | - Veronica Vallejo-Ruiz
- Instituto Mexicano del Seguro Social, Centro de Investigación Biomédica de Oriente, Laboratorio de Biología Molecular, Puebla, Mexico
| | - Fausto Atonal-Flores
- Departamento de Fisiología, Benemérita Universidad Autónoma de Puebla, Facultad de Medicina, Metepec, Mexico
| | - Jorge Flores-Hernandez
- Laboratorio de Neuromodulación, Benemerita Universidad Autonoma de Puebla, Fisiología, Puebla,Mexico
| | - Oswaldo Torres-Ramírez
- Departamento de Farmacia, Benemérita Universidad Autónoma de Puebla, Facultad de Ciencias Químicas, Puebla, Mexico
| | - Alfonso Diaz-Fonsecae
- Departamento de Farmacia, Benemérita Universidad Autónoma de Puebla, Facultad de Ciencias Químicas, Puebla, Mexico
| | - Francisco Perez Vizcaino
- Departamento de Farmacología y Toxicología, Universidad Complutense de Madrid, Escuela de Medicina, Puebla,Mexico
| | - Jose Gustavo Lopez-Lopez
- Departamento de Farmacia, Benemerita Universidad Autonoma de Puebla, Laboratorio de Farmacia Clinica, Edificio FCQ10, Ciudad Universitaria, Col. Jardines de San Manuel, Puebla, Mexico
| |
Collapse
|
4
|
Iasevoli F, Barone A, Buonaguro EF, Vellucci L, de Bartolomeis A. Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review. Expert Opin Drug Saf 2020; 19:1419-1444. [DOI: 10.1080/14740338.2020.1820985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Felice Iasevoli
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Annarita Barone
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Elisabetta Filomena Buonaguro
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Licia Vellucci
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| |
Collapse
|
5
|
Effects of medications on ventricular repolarization in children with attention deficit hyperactivity disorder. Int Clin Psychopharmacol 2020; 35:109-112. [PMID: 31633572 DOI: 10.1097/yic.0000000000000288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder that manifests during childhood. Methylphenidate (MPH), which is a psychostimulant drug, has been often prescribed for the treatment of ADHD in patients. It may increase the risk of fatal arrhythmias by impairing ventricular repolarization. Indicators of ventricular repolarization in ECG are intervals of QT, corrected QT (QTc), QT dispersion (QTd), T-peak to T-end (Tp-e), and Tp-Te/QTc ratio. We aimed to determine ventricular repolarization findings before and after MPH drug therapy in children with ADHD. The study retrospectively examined the medical records of 33 children aged 6-15 years who received MPH for ADHD and who had a control ECG one month after medication. The ECG parameters, heart rate, intervals of QRS, QT, QTc, QTd, Tp-Te, and Tp-Te/QTc ratio, were compared for each patient before and after drug therapy. No significant change was observed in heart rate, QRS, QT, QTc, and QTd interval in ECGs of patients after treatment but pre and posttreatment mean Tp-Te interval was 73.4 ± 9.72 ms and 79.7 ± 10.48 ms, and mean Tp-Te/QTc ratio was 0.17 ± 0.024 and 0.18 ± 0.023, respectively (P = 0.015, P = 0.028). Tp-Te intervals and Tp-Te/QTc ratios remained within normal values after treatment with MPH, but values were higher than baseline.
Collapse
|
6
|
Picarzo JPL, Malfaz FC, Marcos DC, Hernández RC, Soria TF, García BM, Sombrero HR, Rotés AS, Sarquella-Brugada G. Recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease as regards the use of drugs in attention deficit hyperactivity disorder in children and adolescents with a known heart disease, as well as in the general paediatric population: position statement by the Spanish Paediatric Association. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
7
|
Pérez-Lescure Picarzo J, Centeno Malfaz F, Collell Hernández R, Crespo Marcos D, Fernández Soria T, Manso García B, Rojo Sombrero H, Sabaté Rotés A, Sarquella-Brugada G. [Recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease as regards the use of drugs in attention deficit hyperactivity disorder in children and adolescents with a known heart disease, as well as in the general paediatric population: Position statement by the Spanish Paediatric Association]. An Pediatr (Barc) 2020; 92:109.e1-109.e7. [PMID: 31676246 DOI: 10.1016/j.anpedi.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Approved drugs for attention deficit hyperactivity disorder (ADHD) in Spain are methylphenidate, lisdexamphetamine, atomoxetine and guanfacine. Due to adverse cardiovascular effects, mainly increased blood pressure and heart rate, its use in patients with known or undiagnosed heart disease may be controversial. OBJECTIVE To obtain a consensus document from the Spanish Society of Paediatric Cardiology and Congenital Heart Diseases (SECPCC) and experts from other Agencies and Societies as a guide for the paediatric cardiologist and physicians who treat children and adolescents with ADHD. METHODOLOGY An analysis was performed on the bibliography and Clinical Practice Guidelines, technical data sheets approved by the Spanish Agency of Medicines and Health Devices, and the Spanish Ministry of Health Guidelines. A Working Group was formed, with a Coordinator, as well as members of the Clinical Cardiology Working Group and Arrhythmia Group of the SECPCC. This Group produced a preliminary document that was reviewed by a group of external experts and a group of internal experts of the SECPCC with a consensus being reached on the final document. RESULTS The recommendations of the SECPCC and the group of experts are presented on cardiovascular evaluation prior to treatment in children and adolescents with no known cardiovascular disease and with known cardiovascular disease. The recommendations of the SECPCC and the group of experts are also presented on the use of medications for ADHD in children and adolescents with cardiological symptoms with no evidence of heart disease, congenital heart disease, cardiomyopathy, Marfan syndrome and other aortic diseases, hypertension, and arrhythmias.
Collapse
Affiliation(s)
- Javier Pérez-Lescure Picarzo
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Junta Directiva, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España.
| | - Fernando Centeno Malfaz
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Río Hortega, Valladolid, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Rosa Collell Hernández
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitari Sant Joan de Reus, Tarragona, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - David Crespo Marcos
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Teresa Fernández Soria
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Begoña Manso García
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Virgen del Rocío, Sevilla, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Henar Rojo Sombrero
- Servicio de Pediatría, Cardiología Infantil, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Anna Sabaté Rotés
- Cardiología Infantil, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Cardiología Clínica, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| | - Georgia Sarquella-Brugada
- Unidad de Arritmias, Cardiopatías Familiares y Muerte Súbita, Hospital Sant Joan de Déu, Barcelona, España; Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Girona, Girona, España; Recerca Cardiovascular, Institut de Recerca, Fundació Sant Joan de Déu, Barcelona, España; Guard-Heart, European Reference Center, Barcelona, España; Junta Directiva, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España; Grupo de Arritmias, Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas, Madrid, España
| |
Collapse
|
8
|
Hayıroğlu Mİ, Öz A, Keskin M. Do the arrhythmic electrocardiographic parameters merely effected by drugs or by anything influencing myocytes? J Electrocardiol 2017; 51:107. [PMID: 29037424 DOI: 10.1016/j.jelectrocard.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Mert İlker Hayıroğlu
- Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
| | - Ahmet Öz
- Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Muhammed Keskin
- Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|