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

TitleFirst-generation antipsychotics and QTc: any role for mediating variables?
Publication TypeArticolo su Rivista peer-reviewed
Year of Publication2016
AuthorsCarrà, G., Crocamo C., Bartoli F., Lax A., Tremolada M., Lucii C., Martinotti G., Nosè M., Bighelli I., Ostuzzi G., et al.
JournalHuman Psychopharmacology
Volume31
Pagination313-318
ISSN08856222
Keywordsadult, alcohol abuse, alcohol consumption, alcoholism, aripiprazole, article, chlorpromazine, clotiapine, clozapine, corrected QT interval prolongation, cross-sectional study, drug misuse, Female, haloperidol, human, major clinical study, male, mental health service, Middle Aged, neuroleptic agent, olanzapine, priority journal, promazine, QRS complex, QT prolongation, QTc interval, quetiapine, risperidone, T wave
Abstract

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. Results: 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. Conclusions: 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. Copyright © 2016 John Wiley & Sons, Ltd.

Notes

cited By 1

URLhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84978152172&doi=10.1002%2fhup.2540&partnerID=40&md5=5532e0982c659b9a41598ea3fa5ed660
DOI10.1002/hup.2540
Citation KeyCarrà2016313