Cardiac arrhythmias related to psychiatric medication

Summary

This narrative review summarizes current available information about cardiac arrhythmias (QT prolongation, Torsade de pointes Tachycardia [TdP], sudden cardiac death) associated with psychiatric medication. Among the most commonly used antipsychotics, amisulpride and ziprasidone are most frequently associated with TdP. Treatment with some antidepressants (SSRIs, tricyclic antidepressants) is associated with a 5- to 6-fold increase in the incidence of out-of-hospital cardiac arrest. Lithium is associated with bradycardia, T-wave changes and AV-block; anxiolytics of the benzodiazepine group do usually not have cardiac side effects. The combination of multiple drugs (including medications from general medicine) that prolong the QT interval has a particularly high cardiac risk.

Zusammenfassung

Diese narrative Übersichtsarbeit fasst das Wissen über kardiale Arrhythmien (z. B. QT-Zeit-Verlängerung, Torsade de pointes Tachykardie TdP, plötzliche Herztod) unter Psychopharmaka zusammen. Unter den gebräuchlichsten Antipsychotika sind Amisulprid und Ziprasidon am häufigsten mit TdP assoziiert. Die Behandlung mit einigen Antidepressiva (SSRIs, trizyklische Antidepressiva) ist mit einer 5- bis 6-fachen Erhöhung der Inzidenz von ambulanten Herzstillständen assoziiert. Lithiumtherapie ist mit Bradykardie, T-Wellen-Veränderungen und AV-Block assoziiert. Anxiolytika vom Typ der Benzodiazepine zeigen meist keine kardialen Nebenwirkungen. Besonders kardial risikoreich hingegen ist die Kombination von mehreren Medikamenten (auch Nichtpsychopharmaka), die die QT-Zeit verlängern.

Keywords

Psychopharmacology - torsade de pointes - achycardia - sudden cardiac arrest - QT prolongation

Schlüsselwörter

Psychopharmaka - Torsade de pointes - Tachykardie - plötzlicher Herzstilstand - QT-Zeit-Verlängerung

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