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Antipsychotics qtc

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https://www.readbyqxmd.com/read/27893184/ecg-alterations-associated-with-psychotropic-drug-use-and-cacna1c-gene-variants-in-three-independent-samples
#1
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 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 (CATIE, n=515, randomized treatment) were analysed. In both prospective samples, baseline/follow-up changes in ECG parameters were analysed in relation to the number of psychotropic drugs stratified according to their known cardiovascular risk...
November 28, 2016: 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
#2
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...
October 7, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27695596/ziprasidone-as-a-potential-abortive-therapy-for-status-migrainosus
#3
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
#4
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
https://www.readbyqxmd.com/read/27527528/examination-of-qtc-values-in-critically-ill-patients-diagnosed-with-delirium-and-prescribed-atypical-antipsychotics
#5
Nicole Palazzolo, Bridgette Kram, Andrew J Muzyk
OBJECTIVE: To determine the extent of QTc prolongation following administration of an atypical antipsychotic in critically ill patients diagnosed with delirium and to conduct an assessment of risk factors to identify the presence of specific risk factors associated with QTc prolongation in this patient population. METHODS: Patients were included if they were at least 18 years of age, admitted to an Intensive Care Unit (ICU) at the study institution from July 1, 2013 through January 30, 2014, had a documented diagnosis of delirium within their electronic medical record, and received an atypical antipsychotic for delirium during their hospital admission...
August 15, 2016: Current Drug Safety
https://www.readbyqxmd.com/read/27517801/prehospital-ketamine-is-a-safe-and-effective-treatment-for-excited-delirium-in-a-community-hospital-based-ems-system
#6
Thomas R Scaggs, David M Glass, Megan Gleason Hutchcraft, William B Weir
Excited delirium syndrome (ExDS) is defined by marked agitation and confusion with sympathomimetic surge and incessant physical struggle, despite futility, which may lead to profound pathophysiologic changes and sudden death. Severe metabolic derangements, including lactic acidosis, rhabdomyolysis, and hyperthermia, occur. The pathophysiology of excited delirium is a subject of ongoing basic science and clinical research. Positive associations with ExDS include male gender, mental health disorders, and substance abuse (especially sympathomimetics)...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27276059/an-analysis-of-qtc-prolongation-with-atypical-antipsychotic-medications-and-selective-serotonin-reuptake-inhibitors-using-a-large-ecg-record-database
#7
Sang-In Park, Hyungmi An, Anhye Kim, In-Jin Jang, Kyung-Sang Yu, Jae-Yong Chung
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...
August 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27245736/first-generation-antipsychotics-and-qtc-any-role-for-mediating-variables
#8
Giuseppe Carrà, Cristina Crocamo, Francesco Bartoli, Annamaria Lax, Martina Tremolada, Claudio Lucii, Giovanni Martinotti, Michela Nosè, Irene Bighelli, Giovanni Ostuzzi, Mariasole Castellazzi, Massimo Clerici, Corrado Barbui
OBJECTIVE: 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. METHODS: 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...
July 2016: Human Psychopharmacology
https://www.readbyqxmd.com/read/27188270/overview-of-short-and-long-term-tolerability-and-safety-of-brexpiprazole-in-patients-with-schizophrenia
#9
John M Kane, Aleksandar Skuban, Mary Hobart, John Ouyang, Emmanuelle Weiller, Catherine Weiss, Christoph U Correll
Second-generation antipsychotics have demonstrated efficacy for patients with schizophrenia but are associated with wide-ranging side effects. Brexpiprazole, a serotonin-dopamine activity modulator, has demonstrated efficacy in adult patients with schizophrenia. This paper provides an overview of the safety and tolerability of brexpiprazole in patients with schizophrenia through examination of pooled safety data from one Phase 2 and two Phase 3 6-week, short-term studies, and two open-label, 52-week, long-term studies...
July 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27129913/continuation-rate-of-atypical-antipsychotics-after-discharge-when-initiated-in-the-intensive-care-unit
#10
Salia Farrokh, Amber C Castle, Mojdeh Heavner, Margaret A Pisani
PURPOSE: The frequency with which atypical antipsychotics initiated in the intensive care unit (ICU) is unknown. While there is lack of evidence to support the exact duration of treatment, antipsychotics should not be continued chronically for agitation and psychosis related to critical illness. The objective of this study was to determine whether atypical antipsychotics initiated in the ICU at a large tertiary academic medical center were continued after hospital discharge. Safety outcomes were also assessed...
April 28, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27036122/lurasidone-an-antipsychotic-with-antidepressant-effects-in-bipolar-depression
#11
Nicholas A Keks, Judy Hope, David Castle
OBJECTIVE: Lurasidone is a new serotonin-dopamine antagonist atypical antipsychotic which also appears to be effective in bipolar depression. This paper will briefly review the evidence concerning lurasidone. CONCLUSIONS: Lurasidone is an antagonist at dopamine D2, serotonin 5-HT2 and 5-HT7, and partial agonist at 5HT1a receptors; it has no anticholinergic or antihistaminic activity. Rapidly absorbed, it has a half-life of 18 ± 7 hours, will reach steady state in five days and is taken at night with food (absorption is halved on an empty stomach)...
June 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/26933346/the-qt-dispersion-and-qtc-dispersion-in-patients-presenting-with-acute-neurological-events-and-its-impact-on-early-prognosis
#12
Kailash Kumar Rahar, Hans Raj Pahadiya, Kishan Gopal Barupal, C P Mathur, Manoj Lakhotia
AIMS: To find out and investigate whether the QT dispersion and QTc dispersion is related to type and prognosis of the acute stroke in patients presenting within 24 h of the onset of stroke. SETTINGS AND DESIGN: This was a observational study conducted at Mahatma Gandhi Hospital, Dr. SN. Medical College, Jodhpur, during January 2014 to January 2015. SUBJECTS AND METHODS: The patients presented within 24 h of onset of acute stroke (hemorrhagic, infarction, or transient ischemic event) were included in the study...
January 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/26908691/diagnosis-and-management-of-delirium-in-critically-ill-infants-case-report-and-review
#13
Khyati Brahmbhatt, Emily Whitgob
Delirium in children is common but not widely understood by pediatric practitioners, often leading to underdiagnosis and lack of treatment. This presents a significant challenge in the young patients in the PICU who are most at risk for delirium and in whom the core features of delirium are difficult to assess and treat. However, because of the potential increased morbidity and mortality associated with untreated delirium in adults and children, it remains important to address it promptly. The literature for delirium in this age group is limited...
March 2016: Pediatrics
https://www.readbyqxmd.com/read/26840602/antipsychotic-dose-mediates-the-association-between-polypharmacy-and-corrected-qt-interval
#14
MULTICENTER STUDY
Corrado Barbui, Irene Bighelli, Giuseppe Carrà, Mariasole Castellazzi, Claudio Lucii, Giovanni Martinotti, Michela Nosè, Giovanni Ostuzzi
Antipsychotic (AP) drugs have the potential to cause prolongation of the QT interval corrected for heart rate (QTc). As this risk is dose-dependent, it may be associated with the number of AP drugs concurrently prescribed, which is known to be associated with increased cumulative equivalent AP dosage. This study analysed whether AP dose mediates the relationship between polypharmacy and QTc interval. We used data from a cross-sectional survey that investigated the prevalence of QTc lengthening among people with psychiatric illnesses in Italy...
2016: PloS One
https://www.readbyqxmd.com/read/26779966/absence-of-change-in-corrected-qt-interval-in-children-and-adolescents-receiving-antipsychotic-treatment-a-12-month-study
#15
José A Alda, Daniel Muñoz-Samons, Jordina Tor, Jessica Merchán-Naranjo, Cecilia Tapia-Casellas, Inmaculada Baeza, Rosa Calvo-Escalona, Josefina Castro-Fornieles, Carmen Martínez-Cantarero, Patricia Andrés-Nestares, Francisco Fernández-Avilés, Celso Arango
BACKGROUND: Prescriptions of antipsychotic drugs (AP) in children and adolescents have significantly increased in Europe as well as in the United States. However, there is limited evidence of the cardiac safety of second-generation antipsychotics (SGA) in the pediatric population. OBJECTIVE: The aim of the study is to evaluate the cardiac side effects of SGA in children and adolescents, and how they are influenced by clinical, demographic, and treatment factors...
June 2016: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/26717525/effects-of-aripiprazole-on-the-qtc-a-case-report
#16
Adam J Karz, Daniel P McGonigle, Joseph F Goldberg, Charles H Kellner, Brandon S Calenda
The use of neuroleptics in the elderly has been a topic of debate since 2005 when the US Food and Drug Administration issued a black-box warning of increased risk of mortality in elderly patients with dementia-related psychosis. Antipsychotic alternatives such as divalproex are sometimes favored on an "off-label" basis to manage agitation in the demented elderly, and antipsychotic use is often clinically necessary to treat psychosis in older adults, with or without dementia. Concurrently, risk for iatrogenic corrected QT (QTc) prolongation on electrocardiogram (ECG) remains a concern with the use of many antipsychotic agents because of its associated potential for fatal arrhythmias...
December 2015: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/26674884/asenapine-for-bipolar-disorder
#17
REVIEW
Thomas Scheidemantel, Irina Korobkova, Soham Rej, Martha Sajatovic
Asenapine (Saphris(®)) is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD)...
2015: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/26674479/valproic-acid-for-treatment-of-hyperactive-or-mixed-delirium-rationale-and-literature-review
#18
REVIEW
Yelizaveta Sher, Anne Catherine Miller Cramer, Andrea Ament, Sermsak Lolak, José R Maldonado
BACKGROUND: Delirium is the most often encountered psychiatric diagnosis in the general hospital, with an incidence of up to 82% in the intensive care unit setting and with significant detrimental effects on patients' morbidity and mortality. Antipsychotics are often considered the first-line pharmacological treatment of delirium, but their use may be limited by lack of efficacy, existing contraindications (e.g., prolonged QTc intervals), or resulting side effects (e.g., akathisia). Valproic acid (VPA) is a potential alternative or adjunct treatment...
November 2015: Psychosomatics
https://www.readbyqxmd.com/read/26488675/fast-versus-slow-strategy-of-switching-patients-with-schizophrenia-to-aripiprazole-from-other-antipsychotics
#19
RANDOMIZED CONTROLLED TRIAL
Tzung-Jeng Hwang, Wei-Ming Lo, Hung-Yu Chan, Ching-Feng Lin, Ming H Hsieh, Chen-Chun Liu, Chih-Min Liu, Hai-Gwo Hwu, Ching-Hua Kuo, Wei J Chen
This study aimed to compare strategies differing in the speed of switching schizophrenic patients to aripiprazole from other antipsychotic agents, with dual administration for 2 weeks and then tapering off the current antipsychotic in fast (within 1 week) versus slow (within 4 weeks) strategies. This 8-week, open-label, randomized, parallel study assigned patients with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of schizophrenia or schizoaffective disorder to either the fast-switching (n = 38) or slow-switching (n = 41) group...
December 2015: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/26473524/second-generation-antipsychotics-in-a-tertiary-care-hospital-prescribing-patterns-metabolic-profiles-and-drug-interactions
#20
David F Niedrig, Carmen Gött, Anja Fischer, Sabrina T Müller, Waldemar Greil, Guido Bucklar, Stefan Russmann
We carried out an observational study that analyzed population characteristics, metabolic profiles, potentially interacting pharmacotherapy, and related adverse events in second-generation antipsychotics (SGAs) users of a tertiary care hospital. Within our pharmacoepidemiological database derived from electronic medical records of 82,358 hospitalizations, we identified 1136 hospitalizations contributing 9165 patient-days with exposure to SGA. Blood pressure, blood glucose, lipids, and BMI had been documented in 97...
January 2016: International Clinical Psychopharmacology
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