服用精神药物患者的 QTc 间期变化:前瞻性观察研究

Shashidhara Munivenkatappa, V. C. R. Avula, Rakesh Upparakadiyala
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引用次数: 0

摘要

精神药物是治疗精神疾病的常用处方药。有多项研究报告称,使用精神药物会导致 QT 间期(QTc)延长。不过,也有一些研究发现,使用这些药物不会有明显的 QTc 变化风险。 为了评估精神药物对未服药精神病患者 QTc 的影响。 我们的研究是一项前瞻性观察研究,在一家三甲医院进行。研究招募了年龄在 18-45 岁之间、未服药、无合并症或药物使用史的患者。在基线、开始服用精神药物后的第二周和第四周记录心电图以评估 QTc。 有 8 名患者(4%)在基线时出现 QTc 延长,被排除在外。在使用任何一种精神药物治疗 2 周和 4 周后,均未发现有临床意义的 QTc 延长。不过,与服用舍曲林、利培酮和奥氮平的患者相比,服用艾司西酞普兰的患者的 QTc 有显著影响(P = 0.001)(P > 0.05)。 在基线 QTc 正常、无重大疾病或药物使用合并症的年轻患者中,以最佳剂量使用新型精神药物导致 QTc 延长的短期风险似乎很低。
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QTc interval changes among patients on psychotropic medications: A prospective observational study
Psychotropic medications are commonly prescribed for the treatment of psychiatric disorders. Various studies have reported QT interval (QTc) prolongation with the use of psychotropics. However, some studies have found no significant risk of QTc changes with these medications. To assess the effect of psychotropics on QTc in drug-naive psychiatric patients. Our study was a prospective observational study, conducted at a tertiary care hospital. Patients aged 18–45 years, drug-naïve, with no medical comorbidity or substance use history, were recruited for the study. ECG to assess QTc was recorded at baseline, second and fourth week after the starting of psychotropic medications. N =8 (4%) patients had QTc prolongation at baseline and were excluded. No clinically significant QTc prolongation was noticed, after 2 weeks and 4 weeks of treatment with any of the psychotropic medications. However, among patients on escitalopram, a significant effect on QTc was noted (P = 0.001) as compared to those on sertraline, risperidone, and olanzapine (P > 0.05). The short-term risk of QTc prolongation with the use of newer psychotropics at optimal doses appears low among young patients with normal baseline QTc and no significant medical or substance use comorbidity.
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