QTc Prolongation and Psychotropics- Management of Prolonged QTc interval in Psychiatry

Posted on:November 3, 2020
Last Updated: April 22, 2024
Time to read: 8 minutes

QTc interval prolongation and psychotropics represent a critical area of focus in psychiatric care. Some psychotropic drugs are associated with an increased risk of prolonging the QTc interval, which is the time required for the heart to repolarise after each heartbeat.

These medications carry differing risk profiles, with the potential to increase the risk of Torsades de Pointes (TdP), a serious cardiac arrhythmia.

Heart rate-corrected QT interval (QTc) on the ECG is the most widely used and accepted marker for screening for the risk of Torsades de Pointes.

There are no currently clear guidelines with regards to prescribing and monitoring of psychotropic medications in the context of QTc, and this article provides guidance with regards to the use of psychotropic medications and QTc interval prolongation.

We cover key points from [Xiong G et al., 2020] and [Funk M et al., 2020] to assist clinicians in prescribing medications with lower QTc prolongation risk, monitoring requirements and managing QTc prolongation.