NYMC Faculty Publications

Effects of Antidepressants on QT Interval in People with Mental Disorders

DOI

10.5114/aoms.2019.86928

Journal Title

Archives of Medical Science

First Page

727

Last Page

741

Document Type

Review Article

Publication Date

5-2020

Department

Medicine

Abstract

Introduction: Drug-induced QT prolongation is associated with higher cardiovascular mortality.

Material and methods: We conducted a protocol-based comprehensive review of antidepressant-induced QT prolongation in people with mental disorders.

Results: Based on findings from 47 published randomized controlled trials (RCTs), 3 unpublished RCTs, 14 observational studies, 662 case reports of torsades de pointes, and 168 cases of QT prolongation, we conclude that all antidepressants should be used only with licensed doses, and that all patients receiving antidepressants require monitoring of QT prolongation and clinical symptoms of cardiac arrhythmias. Large observational studies suggest increased mortality associated with all antidepressants (RR = 1.62, 95% CI: 1.60-1.63, number of adults: 1,716,552), high doses of tricyclic antidepressants (OR = 2.11, 85% CI 1.10-4.22), selective serotonin reuptake inhibitors (OR = 2.78, 95% CI: 1.24-6.24), venlafaxine (OR = 3.73, 95% CI: 1.33-10.45, number of adults: 4,040), and nortriptyline (OR = 4.60, 95% CI: 1.20-18.40, number of adults: 5,298).

Conclusions: Evidence regarding the risk of QT prolongation in children is sparse.

Link to Full Text

Share

COinS