Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs

Fowler, Noble O.; McCall, David; Chou, Te Chuan; Holmes, John C.; Hanenson, Irwin B.

doi:10.1016/0002-9149(76)90316-7

Cited by 236 publications

(59 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The antipsychotic drugs with low potency of dopamine blockade, the socalled low-potency agents, are chlorproma zine, thioridazine, and mesoridazine. These low-potency antipsychotic drugs have signifi cantly more anticholinergic, alpha-adrenergic blocking, and quinidine-like effects than the high-potency antipsychotic agents, and are therefore associated with more cardiotoxicity [107], Thus, low-potency antipsychotic agents are relatively contraindicated in cardiac pa tients. The high-potency antipsychotics, such as haloperidol, trifluperazine.…”

Section: Pharmacotherapy Of Depressionmentioning

confidence: 99%

Review of Psychosomatic Aspects of Cardiovascular Disease

Littman

1993

Psychother Psychosom

View full text Add to dashboard Cite

This review deals with the clinically most relevant psychosomatic aspects of cardiovascular disease. Smoking cessation, the role of physical activity in the prevention and rehabilitation of cardiac disease, the relationship of cholesterol to behavior, depression and heart disease, the pharmacotherapy of depression in this specific patient population, the psychiatric risk factors for coronary artery disease, and the treatment of hostility, stress and type A behavior are discussed.

show abstract

Section: Pharmacotherapy Of Depressionmentioning

confidence: 99%

Review of Psychosomatic Aspects of Cardiovascular Disease

Littman

1993

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…However, the most common ECG changes are benign and reversible T wave alterations. As in the case of the tricyclic antidepressants, the ECG changes with antipsychotic drugs are also dose dependent [2,15]. The dosage oftricylic antidepressants and antipsychotics given to our patients was at the lower side of therapeu› tic range.…”

Section: Type Of Arrhythmia Drug Treatmentmentioning

confidence: 81%

Effects of Electroconvulsive Therapy on Cardiovascular System

Chaudhary

Rajuria²

1995

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Lt Col 5 CHAUDHARY•, Col 55 RAJURIA+ ABSTRACf Effects of electroconvulsive therapy on the pulse rate, blood pressure and electrocardiogram were studied in forty consecutive physically healthy inpatients undergoing ECf for their psychiatric disabili› ties. Tachycardia and elevated blood pressure occurred frequently. Sinus arrhythmias, atrial and ventricular premature beats and minor ST-T changes were also observed. All these changes reversed within thirty minutes.

show abstract

“…Torsade de pointes has been described after the use of several drugs which prolong the QT interval, including class 1 antiarrhythmic drugs and phenothiazines (Fowler et al, 1976;Meltzer et al, 1978). Although diethylpropion hydrochloride has sympathomimetic actions it has not been reported to prolong the QT interval (Schreiber et al, 1968).…”

Section: Discussionmentioning

confidence: 99%

Ventricular arrhythmias complicating weight reduction therapy in a patient with a prolonged QT interval

O'keefe

Butrous

Dymond

et al. 1985

Postgraduate Medical Journal

View full text Add to dashboard Cite

Summary: Serious ventricular arrhytlmias are known to occur in patients with long QT intervals. We describe a case of torsade de pointes occurring in a patient with a prolonged QT interval while taking a 1000 calorie diet, diethylpropion hydrochloride (Tenuate Dospan) and bendrofluazide. In patients with long QT intervals, hypokalaemia and drugs which further delay repolarization may facilitate the development of life threatening arrhythmias.Case report A 35 year old housewife presented with a 24 h history ofbriefepisodes ofloss ofconsciousness. She had been taking a 1000 calorie diet for 3 weeks; bendrofluazide 5 mg/d and diethylpropion hydrochloride 75 mg/d were added for 10 d prior to admission. On admission the pulse was irregular and the blood pressure was 120/ 80 mm Hg. Cardiovascular and neurological findings were otherwise normal. Biochemical investigations revealed a reduced serum potassium of 2.4 mmol/l (normal range 3.5-4.5 mmol/l). All other biochemical and haematological tests were normal. The electrocardiogram revealed sinus rhythm, with frequent unimorphological ventricular ectopics. The measured QT interval (QTm) was 0.4s during a heart rate of 100 beats/min, and the corrected QT interval (QTc) according to Bazett (1920) was 0.52s (normal less than 0.44 s). The QRS and ST segments were normal and U waves were present. Chest radiograph and echocardiogram were normal.Cardiac monitoring showed episodes of ventricular tachycardia, of a torsade de pointes morphology (Figure 1), associated with episodes of loss of consciousness. Treatment included the withdrawal of bendrofluazide and diethylpropion hydrocholoride, potassium replacement and an intravenous infusion of mexiletine which suppressed ventricular arrhythmias. Two days later when the patient was normokalaemic, the QTc was prolonged at 0.50 s (QTm, 0.42 s, heart rate 85 beats/min) and U waves were absent (Figure 2).Three months later investigations were performed when the serum potassium was 3.9 mmol/l. The electrocardiogram revealed that QTc was persistently prolonged to 0.48 s (QTm 0.42 s, heart rate 77 beats/ min). No ventricular arrhythmias were induced by maximal treadmill exercise testing. An intracardiac electrophysiological study revealed normal conduction times and no ventricular arrhythmias were induced with programmed right ventricular stimulation, either before or after intravenous isoprenaline (7 ,Lg/ min for 5 min). The QTm during identical rates of atrial pacing was unchanged following the isoprenaline infusion. Subsequently. 100 mg/d of atenolol has shortened the QTc to 0.42 s (QTm 0.43 s, heart rate 51 beats/min) and the patient has remained asymp-

show abstract

Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs

Cited by 236 publications

References 27 publications

Review of Psychosomatic Aspects of Cardiovascular Disease

Review of Psychosomatic Aspects of Cardiovascular Disease

Effects of Electroconvulsive Therapy on Cardiovascular System

Ventricular arrhythmias complicating weight reduction therapy in a patient with a prolonged QT interval

Contact Info

Product

Resources

About