Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatment-Resistant Schizophrenia and QT Prolongation
Introduction: Clozapine is regarded as the most effective antipsychotics for patients with treatment-resistant schizophrenia. Of late cardiac safety becomes a principal concern including QTc prolongation that can lead to sudden cardiac death. Objective: This case report will highlight the developm...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Japan International Cultural Exchange Foundation
2018
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| Online Access: | http://eprints.usm.my/45298/1/291-2Nordin.pdf |
| _version_ | 1797011349841117184 |
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| author | Nordin, Muhammad Farhan Othman, Zahiruddin |
| author_facet | Nordin, Muhammad Farhan Othman, Zahiruddin |
| author_sort | Nordin, Muhammad Farhan |
| collection | USM |
| description | Introduction: Clozapine is regarded as the most effective antipsychotics for patients with treatment-resistant schizophrenia.
Of late cardiac safety becomes a principal concern including QTc prolongation that can lead to sudden cardiac death.
Objective: This case report will highlight the development of clozapine-induced QTc prolongation, and subsequent stabilization
with combined aripiprazole and electroconvulsive therapy (ECT) in a patient with treatment-resistant schizophrenia.
Result: We reported a 30-year-old male patient with treatment-resistant schizophrenia who developed QTc prolongation. In
2014, prolonged QTc 521ms was attributed to hypocalcemia. Then in 2016, prolonged QTc 492 ms was noted after the ECT, and
most recently QTc 504 ms while on clozapine 100 mg daily. Other investigations including electrolytes, echocardiogram, thyroid,
renal and liver function tests were normal. Subsequently, the patient was stabilized on combined aripiprazole and ECT. The
QTc ranged 460 to 494 ms while he was on aripiprazole 15 mg daily.
Conclusion: The combined use of aripiprazole and ECT is safe for treatment of treatment-resistant schizophrenia with prolonged
QTc. Close monitoring is recommended since QTc impact of aripiprazole may be additive to the arrhythmia risk. |
| first_indexed | 2024-03-06T15:33:03Z |
| format | Article |
| id | usm.eprints-45298 |
| institution | Universiti Sains Malaysia |
| language | English |
| last_indexed | 2024-03-06T15:33:03Z |
| publishDate | 2018 |
| publisher | Japan International Cultural Exchange Foundation |
| record_format | dspace |
| spelling | usm.eprints-452982019-08-26T08:11:35Z http://eprints.usm.my/45298/ Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatment-Resistant Schizophrenia and QT Prolongation Nordin, Muhammad Farhan Othman, Zahiruddin RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Introduction: Clozapine is regarded as the most effective antipsychotics for patients with treatment-resistant schizophrenia. Of late cardiac safety becomes a principal concern including QTc prolongation that can lead to sudden cardiac death. Objective: This case report will highlight the development of clozapine-induced QTc prolongation, and subsequent stabilization with combined aripiprazole and electroconvulsive therapy (ECT) in a patient with treatment-resistant schizophrenia. Result: We reported a 30-year-old male patient with treatment-resistant schizophrenia who developed QTc prolongation. In 2014, prolonged QTc 521ms was attributed to hypocalcemia. Then in 2016, prolonged QTc 492 ms was noted after the ECT, and most recently QTc 504 ms while on clozapine 100 mg daily. Other investigations including electrolytes, echocardiogram, thyroid, renal and liver function tests were normal. Subsequently, the patient was stabilized on combined aripiprazole and ECT. The QTc ranged 460 to 494 ms while he was on aripiprazole 15 mg daily. Conclusion: The combined use of aripiprazole and ECT is safe for treatment of treatment-resistant schizophrenia with prolonged QTc. Close monitoring is recommended since QTc impact of aripiprazole may be additive to the arrhythmia risk. Japan International Cultural Exchange Foundation 2018-10 Article PeerReviewed application/pdf en http://eprints.usm.my/45298/1/291-2Nordin.pdf Nordin, Muhammad Farhan and Othman, Zahiruddin (2018) Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatment-Resistant Schizophrenia and QT Prolongation. International Medical Journal, 25 (5). pp. 291-292. ISSN 1341-2051 http://www.seronjihou.co.jp/IMJ/backnumber-IMJ.html |
| spellingShingle | RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Nordin, Muhammad Farhan Othman, Zahiruddin Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatment-Resistant Schizophrenia and QT Prolongation |
| title | Combined Aripiprazole and Electroconvulsive Therapy in a
Patient with Treatment-Resistant Schizophrenia and QT
Prolongation |
| title_full | Combined Aripiprazole and Electroconvulsive Therapy in a
Patient with Treatment-Resistant Schizophrenia and QT
Prolongation |
| title_fullStr | Combined Aripiprazole and Electroconvulsive Therapy in a
Patient with Treatment-Resistant Schizophrenia and QT
Prolongation |
| title_full_unstemmed | Combined Aripiprazole and Electroconvulsive Therapy in a
Patient with Treatment-Resistant Schizophrenia and QT
Prolongation |
| title_short | Combined Aripiprazole and Electroconvulsive Therapy in a
Patient with Treatment-Resistant Schizophrenia and QT
Prolongation |
| title_sort | combined aripiprazole and electroconvulsive therapy in a patient with treatment resistant schizophrenia and qt prolongation |
| topic | RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
| url | http://eprints.usm.my/45298/1/291-2Nordin.pdf |
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