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

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, Tiziano Acciavatti, A. Adamo, A. Aguglia, C. Albanese, S. Baccaglini, Francesco Bardicchia, R. BaroneY. Barone, F. Bartoli, C. Bergamini, F. Bertolini, I. Bighelli, S. Bolognesi, A. Bordone, P. Bortolaso, M. Bugliani, C. Calandra, Salvatore Calò, G. Cardamone, M. Caroleo, E. Carra, G. Carrà, D. Carretta, Massimiliano Castellazzi, L. Chiocchi, E. Cinosi, M. Clerici, M. Corbo, E. Corsi, R. Costanzo, G. Costoloni, F. D’Arienzo, S. Debolini, A. De Capua, W. A. Di Napoli, M. Dinelli, E. Facchi, F. Fargnoli, F. Fiori, A. Franchi, F. Gardellin, Chiara Gastaldon, E. Gazzoletti, Lucio Ghio, M. Giacomin, Manuela Gregis, N. Iovieno, D. Koukouna, A. Lax, Camilla Lintas, A. Luca, M. Luca, C. Lucii, M. Lussetti, M. Madrucci, N. Magnani, L. Magni, Laura Rosa Magni, G. Martinotti, C. Martorelli, R. Mattafirri, M. Nosè, G. Ostuzzi, C. Paladini, Davide Papola, M. Percudani, G. Perini, P. Petrosemolo, M. Pezzullo, S. Piantanida, Federica Pinna, K. Prato, D. Prestia, Diego Quattrone, C. Reggianini, F. Restaino, M. Ribolsi, Michele Ribolsi, Carla Rizzo, Raffella Rizzo, M. Roggi, Giovanni Rossi, Giuseppe Rossi, S. Ruberto, M. Santi, R. Santoro, Gianna Sepede, Maria Signorelli, F. Soscia, F. Sozzi, P. Staffa, M. Stilo, Stefania Strizzolo, F. Suraniti, N. Tavian, L. Tortelli, F. Tosoni, M. Valdagno, V. Zanobini, C. Barbui

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)313-318
Number of pages6
JournalHuman Psychopharmacology
DOIs
Publication statusPublished - Jul 1 2016

Keywords

  • alcohol
  • antipsychotic agents
  • drug therapy combination
  • QT prolongation
  • risk factors

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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  • Cite this

    Carrà, G., Crocamo, C., Bartoli, F., Lax, A., Tremolada, M., Lucii, C., Martinotti, G., Nosè, M., Bighelli, I., Ostuzzi, G., Castellazzi, M., Clerici, M., Barbui, C., Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., ... Barbui, C. (2016). First-generation antipsychotics and QTc: any role for mediating variables? Human Psychopharmacology, 313-318. https://doi.org/10.1002/hup.2540