QT Prolongation: Psychotropic medication versus illicit drugs
Introduction Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appra...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822011336/type/journal_article |
| _version_ | 1797616111927164928 |
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| author | A. Florian C. Florian A. Ignat C. Voinea L. Popescu G. Ganea C. Gherghe L. Mateescu |
| author_facet | A. Florian C. Florian A. Ignat C. Voinea L. Popescu G. Ganea C. Gherghe L. Mateescu |
| author_sort | A. Florian |
| collection | DOAJ |
| description |
Introduction
Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appraisal of cardiac consequences is essential as delayed repolarization may lead to the rare but potentially deadly polymorphic ventricular tachycardia.
Objectives
The goal of this presentation is to underscore the cardiac risks associated with both medication use and substance abuse in order to ensure the suitable psychopharmacological treatment, especially in particular situations of drug using patients.
Methods
The subject of the presentation is a 17-year-old female adolescent hospitalized in our clinic, with multiple substance abuse, as seen in qualitative multidrug test (cannabis, amphetamines, ecstasy, barbiturates, benzodiazepines), previously under complex treatment prescribed by an adult psychiatrist (3 atypical antipsychotics, 1 selective serotonin reuptake inhibitor, 1 anticonvulsant, 1 benzodiazepine). Specialty literature has been reviewed concerning the cardiac effects of both the abuse substances and the psychiatric medications.
Results
Multiple drugs involved may cause a myocardial repolarization delay, the patient having a QTc of 508 msec at the admission. Consequent to parenteral fluids and treatment managing, ECG revealed a decrease to 379 msec 7 days later in the stay. This finding could not be viewed solely as caused by drug use, psychiatric medication or individual factors, but rather as their aggregation.
Conclusions
Psychotropic substances use may lead to QT prolongation, which calls for close cardiac supervision whenever patient’s behaviour warrants or when pharmacologic intervention is required.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:36:33Z |
| format | Article |
| id | doaj.art-1544965e06cf4c2eafc0f694dfe79039 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:36:33Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-1544965e06cf4c2eafc0f694dfe790392023-11-17T05:09:24ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S446S44610.1192/j.eurpsy.2022.1133QT Prolongation: Psychotropic medication versus illicit drugsA. Florian0C. Florian1A. Ignat2C. Voinea3L. Popescu4G. Ganea5C. Gherghe6L. Mateescu7“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, Romania“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, Romania“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, Romania“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, Romania“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, RomaniaEmergency Clinical Hospital for Children “M.S.Curie”, Pediatric Cardiology, Bucharest, RomaniaCentral Military Emergency Hospital “Dr. Carol Davila”, Psychiatry, Bucharest, Romania“Prof. Dr. Al. Obregia” Psychiatry Clinical Hospital, Child And Adolescent Psychiatry, Bucharest, Romania Carol Davila University of Medicine and Pharmacy, Child And Adolescent Psychiatry, Bucharest, Romania Introduction Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appraisal of cardiac consequences is essential as delayed repolarization may lead to the rare but potentially deadly polymorphic ventricular tachycardia. Objectives The goal of this presentation is to underscore the cardiac risks associated with both medication use and substance abuse in order to ensure the suitable psychopharmacological treatment, especially in particular situations of drug using patients. Methods The subject of the presentation is a 17-year-old female adolescent hospitalized in our clinic, with multiple substance abuse, as seen in qualitative multidrug test (cannabis, amphetamines, ecstasy, barbiturates, benzodiazepines), previously under complex treatment prescribed by an adult psychiatrist (3 atypical antipsychotics, 1 selective serotonin reuptake inhibitor, 1 anticonvulsant, 1 benzodiazepine). Specialty literature has been reviewed concerning the cardiac effects of both the abuse substances and the psychiatric medications. Results Multiple drugs involved may cause a myocardial repolarization delay, the patient having a QTc of 508 msec at the admission. Consequent to parenteral fluids and treatment managing, ECG revealed a decrease to 379 msec 7 days later in the stay. This finding could not be viewed solely as caused by drug use, psychiatric medication or individual factors, but rather as their aggregation. Conclusions Psychotropic substances use may lead to QT prolongation, which calls for close cardiac supervision whenever patient’s behaviour warrants or when pharmacologic intervention is required. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822011336/type/journal_articlesubstance abusePsychotropic agentselectrocardiogramQT prolongation |
| spellingShingle | A. Florian C. Florian A. Ignat C. Voinea L. Popescu G. Ganea C. Gherghe L. Mateescu QT Prolongation: Psychotropic medication versus illicit drugs European Psychiatry substance abuse Psychotropic agents electrocardiogram QT prolongation |
| title | QT Prolongation: Psychotropic medication versus illicit drugs |
| title_full | QT Prolongation: Psychotropic medication versus illicit drugs |
| title_fullStr | QT Prolongation: Psychotropic medication versus illicit drugs |
| title_full_unstemmed | QT Prolongation: Psychotropic medication versus illicit drugs |
| title_short | QT Prolongation: Psychotropic medication versus illicit drugs |
| title_sort | qt prolongation psychotropic medication versus illicit drugs |
| topic | substance abuse Psychotropic agents electrocardiogram QT prolongation |
| url | https://www.cambridge.org/core/product/identifier/S0924933822011336/type/journal_article |
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