PMID- 33417009
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1435-1463 (Electronic)
IS  - 0300-9564 (Linking)
VI  - 128
IP  - 2
DP  - 2021 Feb
TI  - Pharmacodynamic Drug-Drug interactions of QT-prolonging drugs in hospitalized 
      psychiatric patients.
PG  - 243-252
LID - 10.1007/s00702-020-02291-y [doi]
AB  - At least 170 approved drugs are linked to QT prolongation, which can lead to 
      serious adverse drug reactions (ADRs), such as Torsade de Pointes (TdP). The aim 
      of this study was to analyze the prevalence and type of pharmacodynamic drug-drug 
      interactions (DDIs) between QT-prolonging drugs in psychiatry. The present 
      retrospective analysis used data from a large pharmacovigilance study, conducted 
      in 10 psychiatric hospitals in Germany. Patients medication lists were screened 
      for QT-prolonging drugs, classified according to the Arizona Center for Education 
      and Research on Therapeutics (AZCERT). In total, 27,396 patient cases (46% 
      female) with a mean (+/- standard deviation) age of 47 +/- 18 years were included in 
      the study. Altogether, 83% of the cases received at least one and up to eight 
      QT-prolonging drugs at the same time. Combination of drugs with a known or 
      possible risk for TdP (according to the AZCERT) was detected in 13,670 cases 
      (50%). Most frequently prescribed psychotropic high-risk drugs (n = 48,995) were 
      the antipsychotics pipamperone (n = 6202), quetiapine (n = 5718), prothipendyl 
      (n = 4298), and risperidone (n = 4265). The replacement of high-risk drugs such 
      as tricyclic antidepressants, levomepromazine, melperone, and promethazine with 
      more tolerable drugs could avoid 11% of QT-prolonging drugs and increase the 
      tolerability of psychopharmacological treatment. More than 80% of psychiatric 
      patients receive at least one QT-prolonging drug during their hospital stay, and 
      almost 50% of these drugs are combined in clinical practice. For the prevention 
      of cardiac ADRs, the physician should evaluate the risk for QT prolongation for 
      each drug and patient-specific risk factors before prescribing these drugs or 
      drug combinations.
FAU - Hefner, Gudrun
AU  - Hefner G
AUID- ORCID: 0000-0001-5892-8993
AD  - Department of Psychiatry and Psychotherapy, Vitos Klinikum Hochtaunus, 
      Emil-Sioli-Weg 1-3, 61081, Friedrichsdorf, Germany. 
      Gudrun.Hefner@vitos-rheingau.de.
FAU - Hahn, Martina
AU  - Hahn M
AD  - Psychiatric Hospital, Vitos Klinik Eichberg, Eltville, Germany.
FAU - Hiemke, Christoph
AU  - Hiemke C
AD  - Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, 
      Mainz, Germany.
FAU - Toto, Sermin
AU  - Toto S
AD  - Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical 
      School, Hannover, Germany.
FAU - Wolff, Jan
AU  - Wolff J
AD  - Department of Psychiatry and Psychotherapy, Medical Center-University of 
      Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
AD  - Evangelical Foundation Neuerkerode, Braunschweig, Germany.
FAU - Roll, Sibylle C
AU  - Roll SC
AD  - Psychiatric Hospital, Vitos Klinik Eichberg, Eltville, Germany.
FAU - Klimke, Ansgar
AU  - Klimke A
AD  - Department of Psychiatry and Psychotherapy, Vitos Klinikum Hochtaunus, 
      Emil-Sioli-Weg 1-3, 61081, Friedrichsdorf, Germany.
AD  - Heinrich-Heine-University, Duesseldorf, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210108
PL  - Austria
TA  - J Neural Transm (Vienna)
JT  - Journal of neural transmission (Vienna, Austria : 1996)
JID - 9702341
RN  - 0 (Pharmaceutical Preparations)
SB  - IM
MH  - Drug Interactions
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - *Long QT Syndrome/chemically induced/epidemiology
MH  - Male
MH  - *Pharmaceutical Preparations
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Torsades de Pointes/chemically induced
OTO - NOTNLM
OT  - Adverse drug reaction
OT  - Psychiatry
OT  - Psychotropic drugs
OT  - QT prolongation
OT  - Torsade de pointes
EDAT- 2021/01/09 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/01/08 12:13
PHST- 2020/11/04 00:00 [received]
PHST- 2020/12/14 00:00 [accepted]
PHST- 2021/01/09 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/01/08 12:13 [entrez]
AID - 10.1007/s00702-020-02291-y [pii]
AID - 10.1007/s00702-020-02291-y [doi]
PST - ppublish
SO  - J Neural Transm (Vienna). 2021 Feb;128(2):243-252. doi: 
      10.1007/s00702-020-02291-y. Epub 2021 Jan 8.