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Antipsychotics qtc

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https://www.readbyqxmd.com/read/28914976/haloperidol-versus-5-ht3-receptor-antagonists-for-postoperative-vomiting-and-qtc-prolongation-a-noninferiority-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#1
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jeetinder Kaur Makkar, Anjan Trikha, David Fish, Ashish Sinha
Haloperidol is an antipsychotic with well-known antiemetic potential. It is underutilized for postoperative nausea vomiting due to reported corrected QT interval (QTc) prolongation. This meta-analysis evaluates its safety and efficacy as an antiemetic in the perioperative period. Trials comparing haloperidol to 5-HT3 -receptor antagonists (5-HT3 -RA) for 24 postoperative vomiting incidences published up to May 2017 were searched in the medical database. Comparisons were made for antiemetic efficiency variables (vomiting incidence, rescue antiemetic need, and patients with complete response) during early (until 6 hours) and late postoperative phases...
September 15, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28855066/emergency-department-approach-to-qtc-prolongation
#2
REVIEW
Ali Pourmand, Maryann Mazer-Amirshahi, Sonya Chistov, Youssef Sabha, Damir Vukomanovic, Mohammed Almulhim
QTc prolongation has been associated with increased risk of developing ventricular tachydysrhythmias, particularly Torsades de Pointes (TdP). QTc prolongation is influenced by many factors including congenital causes, heart rate, metabolic imbalances, and pharmacotherapy. Several commonly used medications in the emergency department (ED), such as antipsychotics and antiemetics, are known to prolong the QT interval. In addition, ED patients may present with conditions that may predispose them to QTc prolongation, such as drug overdose or hypokalemia, which can further complicate management...
August 24, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28791627/influence-of-intravenous-administration-of-the-antipsychotic-drug-benperidol-on-the-qt-interval
#3
Alexander Schmidt, Peter Fischer, Beate Wally, Joachim Scharfetter
A group effect is generally assumed regarding the prolongation of the QT interval through butyrophenone antipsychotics like haloperidol. Consequently intravenous administration of benperidol is seen critically notwithstanding sparse evidence; thus benperidol and haloperidol were compared regarding their cardiac risk of prolonging the QT interval when administered intravenously for acute sedation of psychotic patients. The QT interval was measured by a 12-lead ECG. For the correction of QT values Bazett's formula was used...
August 8, 2017: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
https://www.readbyqxmd.com/read/28739492/efficacy-and-safety-of-citalopram-compared-to-atypical-antipsychotics-on-agitation-in-nursing-home-residents-with-alzheimer-dementia
#4
Giovanni Viscogliosi, Iulia Maria Chiriac, Evaristo Ettorre
OBJECTIVE: To assess efficacy and safety of citalopram compared to quetiapine and olanzapine for the treatment of agitation in patients with Alzheimer disease (AD). DESIGN: Longitudinal, 6-month study. SETTING: Nursing home (NH). PARTICIPANTS: 75 NH residents with AD and agitation, randomized to citalopram (n = 25), quetiapine (n = 25), or olanzapine (n = 25). MEASUREMENTS: Changes in Neuropsychiatric Inventory (NPI) agitation subscale score and the modified Alzheimer Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC) were used to assess treatment efficacy...
July 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28705742/an-acute-oral-intoxication-with-haloperidol-decanoate
#5
Bart G J Dekkers, Ruben J Eck, Jan C Ter Maaten, Daniël J Touw
Haloperidol decanoate is a typical antipsychotic drug used as maintenance therapy for schizophrenia and mood disorders formulated as an ester for intramuscular injection. Cases of oral haloperidol decanoate intoxications have not been described in literature. In this report, we present for the first time a case of an oral ingestion of haloperidol decanoate of a young woman who presented to the emergency department following an intentional oral ingestion of 1 ampoule of haloperidol decanoate 100mg. At presentation, she had a bilateral rest tremor of both hands and mild hypothermia...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28703024/safety-and-effectiveness-of-physostigmine-a-10-year-retrospective-review
#6
Ann M Arens, Krishna Shah, Suad Al-Abri, Kent R Olson, Tom Kearney
BACKGROUND: Physostigmine has long been recognized as an antidote to reverse anticholinergic delirium. However, its effectiveness, safety profile, and dosing have been disputed. OBJECTIVES: To describe effectiveness, adverse events, and dosing associated with the use of physostigmine to reverse anticholinergic delirium. METHODS: A retrospective cohort study of hospitalized patients reported to a regional poison center system between 2003 and 2012 who received physostigmine to reverse an anticholinergic toxidrome...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28692485/safety-and-tolerability-of-cariprazine-in-patients-with-acute-exacerbation-of-schizophrenia-a-pooled-analysis-of-four-phase-ii-iii-randomized-double-blind-placebo-controlled-studies
#7
Willie Earley, Suresh Durgam, Kaifeng Lu, István Laszlovszky, Marc Debelle, John M Kane
Cariprazine, a potent dopamine D3 and D2 receptor partial agonist antipsychotic with preferential binding to D3 receptors, is Food and Drug Administration approved for treating schizophrenia and manic or mixed episodes of bipolar I disorder. A post-hoc safety/tolerability analysis of data from the four acute trials in the cariprazine schizophrenia clinical development program (NCT00404573; NCT00694707; NCT01104766; NCT01104779) was carried out using the overall safety population (all patients who received ≥1 dose of study drug) and modal daily dose subgroups (1...
July 7, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28659221/qtc-interval-in-patients-with-schizophrenia-receiving-antipsychotic-treatment-as-monotherapy-or-polypharmacy
#8
Anja Elliott, Thibault Johan Mørk, Mikkel Højlund, Thomas Christensen, Rasmus Jeppesen, Nikolaj Madsen, Anne Grethe Viuff, Peter Hjorth, Jens Cosedis Nielsen, Povl Munk-Jørgensen
OBJECTIVE: Antipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolonged by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia, and measured the frequency of QTc prolongation among patients...
June 29, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28583014/evaluation-of-the-effects-of-quetiapine-on-qtc-prolongation-in-critically-ill-patients
#9
Kevin M Dube, Jeremy DeGrado, Benjamin Hohlfelder, Paul M Szumita
Quetiapine, an atypical antipsychotic used in the intensive care unit (ICU) to manage delirium, has a possible adverse effect of corrected QT (QTc) interval prolongation. The objective of this analysis was to describe the impact of quetiapine on QTc interval prolongation in critically ill patients. This was a single-center, prospective cohort analysis of ICU patients who received quetiapine between October 2015 and February 2016. The major end point was the incidence of QTc prolongation greater than 60 milliseconds above baseline during therapy...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28129701/how-gender-affects-the-pharmacotherapeutic-approach-to-treating-psychosis-a-systematic-review
#10
REVIEW
Bettina Lange, Juliane K Mueller, F Markus Leweke, J Malte Bumb
The effectiveness, effective dosages and side effect profiles of antipsychotic medication differ significantly between the sexes. Areas covered: We present a systematic review of gender-differences in the treatment of psychosis focusing on randomized, controlled trials and meta-analyses. Expert opinion: Despite many years of research, the database on gender-differences affecting the pharmacotherapeutic approach to treating psychosis is insufficient. Currently, the US National Institute of Health encouraged the enrolment of female participants in federally supported phase III clinical trials to increase the data available of female patients...
March 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28116499/lack-of-relationship-between-plasma-levels-of-escitalopram-and-qtc-interval-length
#11
Mar Carceller-Sindreu, Javier de Diego-Adeliño, Maria J Portella, Xavier Garcia-Moll, Maria Figueras, Aina Fernandez-Vidal, Josep M Queraltó, Dolors Puigdemont, Enric Álvarez
Despite safety concerns raised by the European Medicines Agency (EMA), evidence supporting QT-lengthening effects of escitalopram is far to be conclusive. We aimed to evaluate the relationship between escitalopram plasma levels (Escit-PL) and corrected QT-interval length (QTc-length) in 91 outpatients recruited from a hospital setting. Fifteen patients had an abnormally prolonged QTc-interval, and 3 had QTc-intervals ≥500 ms. No correlation between Escit-PL and QTc-length was found (r = 0.08; p = 0.45)...
January 23, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28078208/influence-of-different-second-generation-antipsychotics-on-the-qtc-interval-a-pragmatic-study
#12
Roy E Olsen, Rune A Kroken, Sigmund Bjørhovde, Kristina Aanesen, Hugo A Jørgensen, Else-Marie Løberg, Erik Johnsen
AIM: To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics (SGAs) in psychosis. METHODS: Data were drawn from a pragmatic, randomized head-to-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequence of the SGAs under investigation...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28008301/iloperidone-in-the-treatment-of-schizophrenia-an-evidence-based-review-of-its-place-in-therapy
#13
REVIEW
Fernanda S Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo
INTRODUCTION: Schizophrenia is a chronic and debilitating mental disorder that affects the patient's and their family's quality of life, as well as financial costs and health care settings. Despite the variety of available antipsychotics, optimal treatment outcomes are not always achieved. Novel drugs, such as iloperidone, can provide more effective, tolerable and safer strategies. AIM: To review the evidence for the clinical impact of iloperidone on the treatment of patients with schizophrenia...
2016: Core Evidence
https://www.readbyqxmd.com/read/28002167/haloperidol-versus-ondansetron-for-treatment-of-established-nausea-and-vomiting-following-general-anesthesia-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Vanda G Yazbeck-Karam, Sahar M Siddik-Sayyid, Hanane B Barakat, Serge Korjian, Marie T Aouad
BACKGROUND: Haloperidol is an antipsychotic. At low doses, it is a useful agent for the prophylaxis of postoperative nausea and vomiting (PONV). However, its use for treating established PONV has not been well studied. METHODS: This randomized double-blinded trial tested whether haloperidol is noninferior to ondansetron for the early treatment of established PONV in adult patients undergoing general anesthesia. The primary outcome is whether patients were PONV free during the first 4 hours...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27996317/cardiac-arrest-with-clozapine-and-olanzapine-revealing-long-qt-syndrome
#15
Edward Woloszyn, Nishant Whig, Eileen Trigoboff, Jeffery J Grace
The authors describe a rare case of "concealed" congenital Long QT Syndrome (LQTS) Type 3 in a patient with treatment resistant schizophrenia and no known personal or family history of cardiac disease. The patient in this Case Report had a hidden genetic condition revealed only following the essential administration of antipsychotics. As a result, this patient experienced an aborted cardiac arrest and a total of five episodes of ventricular tachycardia (VT) requiring cardioversion. Successful control of the VT occurred with an Automatic Internal Defibrillator (AID), judicious use of antipsychotic medications, and anti-arrhythmic medications...
December 20, 2016: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/27930499/prevalence-and-risk-factors-of-prolonged-corrected-qt-interval-among-children-and-adolescents-treated-with-antipsychotic-medications-a-long-term-follow-up-in-a-real-world-population
#16
Inmaculada Palanca-Maresca, Belén Ruiz-Antorán, Gustavo Adolfo Centeno-Soto, Maria Azul Forti-Buratti, Ana Siles, Ana Usano, Cristina Avendaño-Solá
PURPOSE: This study aimed to describe the prevalence of corrected QT (QTc) interval disorders and the possible predisposing factors in children and adolescents treated with antipsychotic (AP) medications in a real-world population with a long-term follow-up. METHODS: Data were obtained from the SafEty of NeurolepTics in Infancy and Adolescence (SENTIA) registry (https://sentia.es). The SENTIA includes patients younger than 18 years who are currently taking or initiating treatment with AP medications and have agreed to participate in the registry...
February 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27893184/electrocardiogram-alterations-associated-with-psychotropic-drug-use-and-cacna1c-gene-variants-in-three-independent-samples
#17
RANDOMIZED CONTROLLED TRIAL
Chiara Fabbri, Giuseppe Boriani, Igor Diemberger, Maria Giulia Filippi, Gloria Ravegnini, Patrizia Hrelia, Alessandro Minarini, Diego Albani, Gianluigi Forloni, Sabrina Angelini, Alessandro Serretti
Several antipsychotics and antidepressants have been associated with QTc prolongation or other electrocardiogram (ECG) alterations, but their impact is still debated and other risk factors are known to affect QTc. We investigated the effect of antidepressants and antipsychotics on QTc and other ECG intervals/waves in three samples. Two discovery samples (cross-sectional sample n = 145 and prospective sample n = 68, naturalistic treatment) and a replication prospective sample (Clinical Antipsychotic Trials of Intervention Effectiveness, n = 515, randomized treatment) were analysed...
May 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27727006/qtc-interval-lengthening-in-first-episode-schizophrenia-fes-patients-in-the-earliest-stages-of-antipsychotic-treatment
#18
Desheng Zhai, Yan Lang, Gaopan Dong, Yijun Liu, Xin Wang, Dushuang Zhou, Taizhen Cui, Yuxin Yang, Wenxi Zhang, Ying Zhao, Ruiling Zhang
Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4weeks) of antipsychotic treatments, compared with baseline...
January 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/27695596/ziprasidone-as-a-potential-abortive-therapy-for-status-migrainosus
#19
Eric C Landsness, Leo H Wang, Robert C Bucelli
Migraine headache is among the most prevalent neurologic disorders. Status migrainosus often leads to hospitalization, and multiple medications are sometimes required for symptomatic relief. In 2008, neurologists at our institution started using the atypical antipsychotic ziprasidone as an abortive medication for status migrainosus. The Clinical Investigation Data Exploration Repository was used to search for patients admitted to the Barnes-Jewish Hospital inpatient neurology service with diagnoses of "headache" or "migraine...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27570623/a-case-of-iloperidone-overdose-in-a-27-year-old-man-with-cocaine-abuse
#20
Jin Amon, Elsa Stephen, Rif S El-Mallakh
INTRODUCTION: Iloperidone is a recently introduced antipsychotic medication. It is approved for the treatment of schizophrenia. There are no published reports of iloperidone overdosage, but there are eight cases that have been reported to the US Food and Drug Administration. CASE REPORT: A case of a 27-year-old man who took 84 mg of iloperidone while also smoking cocaine is described. He developed a prolonged QTc (527 ms) without arrhythmias and respiratory failure with mandated respiratory support...
2016: SAGE open medical case reports
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