The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients
Abstract
:1. Introduction
2. Materials and Methods
- RR interval
- PR interval
- TpTe interval [the interval between the peak and the end of the T wave (Tpeak to Tend)] [19]
- TpTe interval divided by QT interval
- Morphological changes of T wave
- Fragmented QRS
3. Results
3.1. Patient Demographic and Clinical Data
3.2. Description of Psychotropic Medications
3.3. ECG Changes Caused by Psychotropic Drugs
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patient Characteristic | |
---|---|
Gender, n (%) | |
Male | 141 (45.9) |
Female | 166 (54.1) |
Age, Mean (SD) (range) | 36.26 (13.48) (18–81) |
BMI, Mean (SD) (range) | 26.66 (5.07) (16.40–47.94) |
Smoker, a n (%) | 113 (36.8) |
Alcohol, a n (%) | 10 (3.3) |
Caffeine, a n (%) | 233 (75.9) |
Physical activity, a n (%) | 61 (19.9) |
Psychiatric conditions, n (%) | |
Anxiety disorders | 127 (41.4) |
Major depressive disorder | 88 (28.7) |
Bipolar disorder | 53 (17.3) |
Schizophrenia | 15 (4.9) |
Others | 24 (7.8) |
Non-psychiatric conditions, n (%) | |
Cardiovascular disease b | 34 (5.9) |
Hypertension | 26 (8.4) |
Diabetes mellitus | 17 (5.6) |
Hypothyroidism | 5 (1.6) |
Epilepsy | 5 (1.6) |
Asthma | 4 (1.3) |
Others | 24 (7.8) |
Name of Class and Medication | Frequency | % |
---|---|---|
SSRIs | 226 | 100 |
Citalopram | 118 | 52.2 |
Fluoxetine | 65 | 28.2 |
Fluvoxamine | 19 | 8.4 |
Escitalopram | 17 | 7.5 |
Sertraline | 4 | 1.8 |
Paroxetine | 3 | 1.3 |
SNRIs | 3 | 100 |
Venlafaxine | 2 | 66.7 |
Duloxetine | 1 | 33.3 |
TCAs | 35 | 100 |
Melitracen | 18 | 51.4 |
Amitriptyline | 13 | 37.1 |
Clomipramine | 4 | 11.4 |
Other antidepressants | ||
Mirtazapine | 8 | 100 |
FGAs | 33 | 100 |
Flupentixol | 26 | 78.8 |
Haloperidol | 3 | 9.1 |
Sulpiride | 1 | 3.0 |
Zuclopentixol | 3 | 9.1 |
SGAs | 158 | 100 |
Quetiapine | 73 | 46.2 |
Olanzapine | 44 | 27.9 |
Risperidone | 29 | 18.4 |
Amisulpiride | 7 | 4.4 |
Aripiprazole | 2 | 1.3 |
Clozapine | 2 | 1.3 |
Ziprasidone | 1 | 0.6 |
Mood stabilizers | 69 | 100 |
Valproate | 27 | 39.1 |
Lamotrigine | 21 | 30.4 |
Lithium | 13 | 18.8 |
Carbamazepine | 8 | 11.6 |
Benzodiazepines | 24 | 100 |
Bromazepam | 17 | 70.8 |
Alprazolam | 5 | 20.8 |
Clonazepam | 2 | 8.3 |
Therapy | QT # (ms) (Uncorrected) | RR (ms) | PR (ms) | TpTe (ms) | TpTe/QT |
---|---|---|---|---|---|
FGAs | |||||
Yes (n = 33) | 366 ± 23 | 762 ± 142 | 152 ± 20 | 76 ± 16 | 0.21 ± 0.04 |
No (n = 274) | 371 ± 28 | 806 ± 132 | 148 ± 19 | 84 ± 93 | 0.22 ± 0.23 |
F | 2.97 | 2.72 | 0.30 | 0.01 | |
p-value | 0.086 | 0.100 | 0.58 | 0.94 | |
SGAs | |||||
Yes (n = 159) | 369 ± 27 | 783 ± 129 | 146 ± 18 | 84 ± 96 | 0.24 ± 0.24 |
No (n = 148) | 373 ± 28 | 821 ± 1362.66 | 150 ± 193.19 | 81 ± 790.01 | 0.22 ± 0.19 |
F | 0.10 | 0.08 | 1.00 | 0.6 | |
p-value | |||||
Quetiapine | |||||
Yes (n = 73) | 368 ± 26 | 780 ± 125 | 148 ± 17 | 97 ± 14 | 0.26 ± 0.35 |
No (n = 234) | 371 ± 28 | 808 ± 136 | 148 ± 19 | 78 ± 64 | 0.21 ± 0.16 |
F | 0.83 | 0.02 | 0.41 | 0.37 | |
p-value | 0.36 | 0.92 | 0.52 | 0.54 | |
SSRIs | |||||
Yes (n = 226) | 375 ± 27 | 814 ± 134 | 148 ± 18 | 86 ± 10 | 0.23 ± 0.25 |
No (n = 81) | 359 ± 26 | 767 ± 127 | 148 ± 21 | 72 ± 18 | 0.20 ± 0.05 |
F | 3.73 | 0.01 | 0.07 | 0.62 | |
p-value | 0.06 | 0.94 | 0.80 | 0.43 | |
Citalopram | |||||
Yes (n = 118) | 376 ± 29 | 814 ± 137 | 150 ± 18 | 75 ± 19 | 0.20 ± 0.05 |
No (n = 189) | 367 ± 26 | 794 ± 132 | 147 ± 19 | 87 ± 12 | 24 ± 0.27 |
F | 0.32 | 1.07 | 0.19 | 0.01 | |
p-value | 0.58 | 0.30 | 0.66 | 0.91 | |
TCAs | |||||
Yes (n = 35) | 369 ± 21 | 759 ± 109 | 152 ± 13 | 74 ± 13 | 0.20 ± 0.05 |
No (n = 271) | 371 ± 28 | 808 ± 136 | 148 ± 19 | 84 ± 93 | 0.23 ± 0.23 |
F | 5.93 | 1.81 | 0.08 | 0.01 | |
p-value | 0.02 | 0.18 | 0.77 | 0.96 | |
Mood stabilizers | |||||
Yes (n = 69) | 363 ± 27 | 784 ± 132 | 149 ± 21 | 73 ± 16 | 0.20 ± 0.04 |
No (n= 238) | 373 ± 27 | 807 ± 134 | 148 ± 18 | 86 ± 100 | 0.23 ± 0.25 |
F | 0.89 | 0.01 | 0.38 | 0.01 | |
p-value | 0.35 | 0.96 | 0.54 | 0.95 | |
Polytherapy | |||||
Yes (n = 184) | 369 ± 27 | 782 ± 127 | 148 ± 20 | 81 ± 87 | 0.23 ± 0.22 |
No (n = 123) | 372 ± 28 | 830 ± 1397.61 | 148 ± 19 | 83 ± 89 | 0.22 ± 0.21 |
F | 0.01 | 0.02 | 0.18 | 0.01 | |
p-value | 0.88 | 0.68 | 0.96 |
Interval | Type of Therapy | n | Mean Rank | X2 |
---|---|---|---|---|
RR | None | 23 | 148 | 5.79 |
SSRI | 125 | 170 | ||
SGA | 58 | 124 | ||
SSRI + SGA | 101 | 153 | ||
PR | None | 23 | 177 | 4.87 |
SSRI | 125 | 163 | ||
SGA | 58 | 138 | ||
SSRI + SGA | 101 | 147 | ||
TpTe | None | 23 | 146 | 4.47 |
SSRI | 123 | 153 | ||
SGA | 55 | 144 | ||
SSRI + SGA | 100 | 153 | ||
TpTe/QT | None | 23 | 165 | |
SSRI | 123 | 148 | ||
SGA | 55 | 158 | 1.57 | |
SSRI + SGA | 100 | 148 |
RR (ms) | PR (ms) | TpTe (ms) | TpTe/QT | ||
---|---|---|---|---|---|
SGAs (n = 159) | Age | ||||
Pearson correlation | 0.074 | 0.282 | −0.006 | −0.013 | |
Sig (2-tailed) | 0.360 | <0.001 | 0.943 | 0.870 | |
BMI | |||||
Pearson correlation | 0.005 | 0.023 | −0.069 | −0.069 | |
Sig (2-tailed) | 0.952 | 0.786 | 0.416 | 0.415 | |
n of psychotropic medications | |||||
Pearson correlation | −0.055 | 0.021 | −0.030 | −0.031 | |
Sig (2-tailed) | 0.494 | 0.795 | 0.715 | 0.700 | |
Quetiapine (n = 73) | Age | ||||
Pearson correlation | 0.099 | 0.169 | −0.074 | −0.081 | |
Sig (2-tailed) | 0.414 | 0.161 | 0.549 | 0.511 | |
BMI | |||||
Pearson correlation | 0.086 | 0.050 | −0.128 | −0.133 | |
Sig (2-tailed) | 0.487 | 0.688 | 0.307 | 0.287 | |
n of psychotropic medications | |||||
Pearson correlation | 0.030 | −0.096 | −0.084 | −0.083 | |
Sig (2-tailed) | 0.801 | 0.421 | 0.485 | 0.492 | |
SSRIs(n = 226) | Age | ||||
Pearson correlation | 0.064 | 0.247 | −0.40 | 0.60 | |
Sig (2-tailed) | 0.344 | <0.001 | 0.562 | 0.374 | |
BMI | |||||
Pearson correlation | 0.033 | 0.091 | −0.097 | −0.104 | |
Sig (2-tailed) | 0.638 | 0.185 | 0.160 | 0.133 | |
n of psychotropic medications | |||||
Pearson correlation | −0.178 | 0.036 | −0.036 | −0.030 | |
Sig (2-tailed) | 0.007 | 0.591 | 0.594 | 0.654 | |
Citalopram (n = 118) | Age | ||||
Pearson correlation | 0.122 | 0.330 | 0.043 | −0.018 | |
Sig (2-tailed) | 0.91 | <0.001 | 0.646 | 0.849 | |
BMI | |||||
Pearson correlation | 0.105 | 0.148 | 0.009 | −0.045 | |
Sig (2-tailed) | 0.286 | 0.122 | 0.929 | 0.643 | |
n of psychotropic medications | |||||
Pearson correlation | −0.109 | 0.069 | −0.002 | 0.012 | |
Sig (2-tailed) | 0.240 | 0.457 | 0.984 | 0.895 | |
Mood stabilizers (n = 69) | Age | ||||
Pearson correlation | 0.165 | 0.086 | −0.074 | −0.141 | |
Sig (2-tailed) | 0.186 | 0.491 | 0.553 | 0.259 | |
BMI | |||||
Pearson correlation | −0.138 | −0.121 | −0.126 | −0.056 | |
Sig (2-tailed) | 0.285 | 0.350 | 0.328 | 0.666 | |
n of psychotropic medications | |||||
Pearson correlation | −0.096 | −0.026 | 0.153 | 0.148 | |
Sig (2-tailed) | 0.433 | 0.831 | 0.208 | 0.225 | |
Polytherapy (n = 184) | Age | ||||
Pearson correlation | 0.034 | 0.236 | −0.007 | −0.14 | |
Sig (2-tailed) | 0.649 | 0.002 | 0.929 | 0.851 | |
BMI | |||||
Pearson correlation | −0.018 | 0.050 | −0.071 | −0.070 | |
Sig (2-tailed) | 0.819 | 0.517 | 0.367 | 0.370 | |
n of psychotropic medications | |||||
Pearson correlation | −0.072 | 0.038 | −0.064 | −0.060 | |
Sig (2-tailed) | 0.334 | 0.610 | 0.389 | 0.419 | |
Total sample (n = 307) | Age | ||||
Pearson correlation | 0.038 | 0.252 | −0.025 | −0.035 | |
Sig (2-tailed) | 0.517 | <0.001 | 0.666 | 0.552 | |
BMI | |||||
Pearson correlation | −0.11 | 0.053 | −0.090 | −0.093 | |
Sig (2-tailed) | 0.849 | 0.374 | 0.131 | 0.120 | |
n of psychotropic medications | |||||
Pearson correlation | −0.174 | 0.013 | −0.020 | −0.014 | |
Sig (2-tailed) | 0.002 | 0.823 | 0.732 | 0.805 |
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Bulatova, N.; Altaher, N.; BaniMustafa, R.; Al-Saleh, A.; Yasin, H.; Zawiah, M.; Khalefah, H.; Ghilan, M.; Al-Lahham, A.; Hudaib, M.; et al. The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients. Biomedicines 2023, 11, 13. https://doi.org/10.3390/biomedicines11010013
Bulatova N, Altaher N, BaniMustafa R, Al-Saleh A, Yasin H, Zawiah M, Khalefah H, Ghilan M, Al-Lahham A, Hudaib M, et al. The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients. Biomedicines. 2023; 11(1):13. https://doi.org/10.3390/biomedicines11010013
Chicago/Turabian StyleBulatova, Nailya, Noor Altaher, Radwan BaniMustafa, Akram Al-Saleh, Haya Yasin, Mohammed Zawiah, Hala Khalefah, Mokhtar Ghilan, Ala’a Al-Lahham, Mohummad Hudaib, and et al. 2023. "The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients" Biomedicines 11, no. 1: 13. https://doi.org/10.3390/biomedicines11010013
APA StyleBulatova, N., Altaher, N., BaniMustafa, R., Al-Saleh, A., Yasin, H., Zawiah, M., Khalefah, H., Ghilan, M., Al-Lahham, A., Hudaib, M., AlKhawaldeh, B., & Nasr, M. (2023). The Effect of Antipsychotics and Their Combinations with Other Psychotropic Drugs on Electrocardiogram Intervals Other Than QTc among Jordanian Adult Outpatients. Biomedicines, 11(1), 13. https://doi.org/10.3390/biomedicines11010013