New research published in the journal Heart Rhythm suggests that patients taking certain antipsychotic drugs have an increased risk of developing heart rhythm disorders and experiencing sudden cardiac death.
The study was a retrospective analysis of electronic medical records from over 11,000 patients in Taiwan. Of those, about 8,800 were taking an antipsychotic called quetiapine and about 2,300 were taking an antipsychotic called haloperidol. These are both common drugs mainly used for the treatment of schizophrenia and psychosis. Participants in the study had electrocardiograms at both baseline and follow-up. The goal of the study was to measure the incidence, risk factors, and outcomes of severe QT prolongation (a problem with the heart’s electrical system that can lead to ventricular arrhythmias and sudden cardiac death) in patients taking either of these two antipsychotics.
The results showed that over 10% of the participants in the study developed severe QT prolongation during the follow-up period. These patients showed an increased risk of ventricular arrhythmias and sudden cardiac death.
The increased cardiac risk associated with antipsychotics has been known for at least the last 30 years, and some drugs have been taken off the market due to severe risks. However, many drugs, such as quetiapine and haloperidol, have remained on the market in spite of their risks because they fulfill an important clinical need and because there are no safer alternatives. Taking antipsychotic drugs generally approximately doubles the risk of sudden cardiac death. Given that the clinical benefits outweigh these risks in many cases, the best step forward is carefully identifying and monitoring patients who are at increased risk. In addition, implementing appropriate risk mitigation strategies and informing patients and caregivers about the risks can help maximize both benefits and overall safety.
Sources: Heart Rhythm, Science Daily