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Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics

Journal Article


Abstract


  • Objective The rate-corrected electrocardiographic QT (QTc) interval may significantly increase in patients with schizophrenia taking antipsychotics. The objective of this naturalistic study was to assess the prevalence of prolonged QTc interval in a large population of inpatients with chronic schizophrenia and to explore QTc relationship with demographic variables and prescribed treatments. Materials and methods Electrocardiograms were obtained from age- and sex-matched 456 controls and 1,006

    inpatients with schizophrenia (male/female=689/317) taking antipsychotics. QTc prolongation was defined as a mean value of two standard deviations above the controls. The adjusted relative risk was calculated using logistic regression analysis. Results QTc prolongation was present in 45 (4.5%) of

    1,006 patients overall. Fewer men (3.2%, 22 of 689) than women (7.3%, 23 of 317) displayed QTc prolongation (p<0.004). Moreover, QTc intervals were shorter in male (391±31 ms) than female subjects (400±37 ms) (p<0.001). Clozapine was found to produce a longer QTc intervals compared to risperidone and typical antipsychotics. Furthermore, multiple regression analysis showed that significant

    predictors for QTc prolongation were comorbid cardiovascular disease, antipsychotic types, sex, and age

    (all p<0.01).

    Conclusion Our present findings suggest that there are sex differences in the prevalence of QTc prolongation and QTc lengthening in schizophrenia. Antipsychotic types are risk factors for QTc prolongation, and risks are substantially higher for clozapine.

    Keywords Schizophrenia . Antipsychotics . QT prolongation . Electrocardiography

Authors


  •   Yang, Fu-De (external author)
  •   Wang, Xiang Qun. (external author)
  •   Liu, Xiu Ping. (external author)
  •   Zhao, Ke Xin. (external author)
  •   Fu, Wei Hong. (external author)
  •   Hao, Xue Ru. (external author)
  •   Zhang, Xing Li. (external author)
  •   Huang, Guo Shu. (external author)
  •   Qu, Sheng Cai. (external author)
  •   Bai, Jing Shen. (external author)
  •   Huang, Xu-Feng
  •   Kosten, Thomas R. (external author)
  •   Zhang, Xiang Yang (external author)

Publication Date


  • 2011

Citation


  • Yang, F. De., Wang, X. Qun., Liu, X. Ping., Zhao, K. Xin., Fu, W. Hong., Hao, X. Ru., Zhang, X. Li., Huang, G. Shu., Qu, S. Cai., Bai, J. Shen., Huang, X., Kosten, T. R. & Zhang, X. Yang. (2011). Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics. Psychopharmacology, 216 (1), 9-16.

Scopus Eid


  • 2-s2.0-79959958729

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3521

Has Global Citation Frequency


Number Of Pages


  • 7

Start Page


  • 9

End Page


  • 16

Volume


  • 216

Issue


  • 1

Abstract


  • Objective The rate-corrected electrocardiographic QT (QTc) interval may significantly increase in patients with schizophrenia taking antipsychotics. The objective of this naturalistic study was to assess the prevalence of prolonged QTc interval in a large population of inpatients with chronic schizophrenia and to explore QTc relationship with demographic variables and prescribed treatments. Materials and methods Electrocardiograms were obtained from age- and sex-matched 456 controls and 1,006

    inpatients with schizophrenia (male/female=689/317) taking antipsychotics. QTc prolongation was defined as a mean value of two standard deviations above the controls. The adjusted relative risk was calculated using logistic regression analysis. Results QTc prolongation was present in 45 (4.5%) of

    1,006 patients overall. Fewer men (3.2%, 22 of 689) than women (7.3%, 23 of 317) displayed QTc prolongation (p<0.004). Moreover, QTc intervals were shorter in male (391±31 ms) than female subjects (400±37 ms) (p<0.001). Clozapine was found to produce a longer QTc intervals compared to risperidone and typical antipsychotics. Furthermore, multiple regression analysis showed that significant

    predictors for QTc prolongation were comorbid cardiovascular disease, antipsychotic types, sex, and age

    (all p<0.01).

    Conclusion Our present findings suggest that there are sex differences in the prevalence of QTc prolongation and QTc lengthening in schizophrenia. Antipsychotic types are risk factors for QTc prolongation, and risks are substantially higher for clozapine.

    Keywords Schizophrenia . Antipsychotics . QT prolongation . Electrocardiography

Authors


  •   Yang, Fu-De (external author)
  •   Wang, Xiang Qun. (external author)
  •   Liu, Xiu Ping. (external author)
  •   Zhao, Ke Xin. (external author)
  •   Fu, Wei Hong. (external author)
  •   Hao, Xue Ru. (external author)
  •   Zhang, Xing Li. (external author)
  •   Huang, Guo Shu. (external author)
  •   Qu, Sheng Cai. (external author)
  •   Bai, Jing Shen. (external author)
  •   Huang, Xu-Feng
  •   Kosten, Thomas R. (external author)
  •   Zhang, Xiang Yang (external author)

Publication Date


  • 2011

Citation


  • Yang, F. De., Wang, X. Qun., Liu, X. Ping., Zhao, K. Xin., Fu, W. Hong., Hao, X. Ru., Zhang, X. Li., Huang, G. Shu., Qu, S. Cai., Bai, J. Shen., Huang, X., Kosten, T. R. & Zhang, X. Yang. (2011). Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics. Psychopharmacology, 216 (1), 9-16.

Scopus Eid


  • 2-s2.0-79959958729

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3521

Has Global Citation Frequency


Number Of Pages


  • 7

Start Page


  • 9

End Page


  • 16

Volume


  • 216

Issue


  • 1