SSRIs in Rett syndrome

Brook, Emma; Usman, Mohammed Aliyu

doi:10.1177/0004867415573057

Cited by 5 publications

(2 citation statements)

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“…Certain medications, including selective serotonin reuptake inhibitors (SSRIs), are known to cause prolongation of the QT interval . These medications and other agents with effects on serotonin have been shown to have a positive impact on behaviour, sleep, and respiratory patterns in patients with RTT . Our goal was to evaluate patients with RTT with prolonged QTc at baseline and monitor patients with normal QTc to evaluate who would develop QTc prolongation over time.…”

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confidence: 99%

“…14 These medications and other agents with effects on serotonin have been shown to have a positive impact on behaviour, sleep, and respiratory patterns in patients with RTT. [15][16][17] Our goal was to evaluate patients with RTT with prolonged QTc at baseline and monitor patients with normal QTc to evaluate who would develop QTc prolongation over time. The identification of patients who develop prolonged QTc and determination of potential risk factors may allow for proper surveillance and monitoring of patients with RTT.…”

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Serial follow‐up of corrected QT interval in Rett syndrome

Clark

Kopp

Morey

et al. 2019

Develop Med Child Neuro

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Aim To identify factors associated with baseline prolonged corrected QT (QTc) and higher risk of QTc prolongation during follow‐up in patients with Rett syndrome (RTT). Method A retrospective review of patients receiving an electrocardiogram (ECG) between June 2012 and June 2018 was performed. Age, methyl‐CpG binding protein 2 gene (MECP2) mutation, RTT Severity Scale (RSSS) score, breathing abnormalities, seizure frequency, medications, and ECG parameters were collected. Prolonged QTc was defined as greater than or equal to 460ms. Comparisons at baseline and during follow‐up were made. Results In total, 129 unique patients (all female) had 349 ECGs. At baseline, 12 (9.3%) had a prolonged QTc (median 474ms, interquartile range 470–486ms) and were more likely to have moderate/severe breathing abnormalities (66.7% vs 24.8%; p=0.005) and take selective serotonin reuptake inhibitors (SSRIs) (41.7% vs 15.4%; p=0.04). There was no difference in age, RSSS score, seizures, or mutation. Twenty‐six developed prolonged QTc during a median follow‐up of 1 year 7 months (interquartile range 0–3y 6mo). QTc prolongation was associated with p.(Thr158Met) mutation versus the remaining six common mutations (hazard ratio 4.1, 95% confidence interval 1.4–12.0; p=0.01) but not with age, RSSS score, seizures, breathing abnormalities, or SSRIs. Interpretation Breathing abnormalities and SSRIs were associated with baseline QTc prolongation and those with p.(Thr158Met) mutation were more likely to develop prolonged QTc over time. Identification of patients with prolonged QTc warrants increased clinical monitoring. What this paper adds Breathing abnormalities and selective serotonin reuptake inhibitors are associated with prolonged baseline corrected QT (QTc). Development of QTc prolongation is associated with the p.(Thr158Met) mutation.

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confidence: 99%