Antipsychotic Drugs and QT Interval Prolongation | SpringerLink
Proarrhythmia caused by a QT-prolonging drug occurs infrequently, and
usually multiple factors need to operate to precipitate such an event
including a combination of two or more drugs affecting the same pathway,
hypokalemia, and possibly genetic predisposition. Currently prescribed
antipsychotics might cause QT prolongation ranging from 4–6 ms for
haloperidol and olanzapine to 35 ms for thioridazine. The response of a
patient to a drug is very individual and therefore an individualized
system of drug administration and monitoring needs to be developed which
takes into account baseline QTc duration and its changes after a drug
was introduced. A systematic approach while stratifying psychiatric
patients as those with short QTc (QTc ≤ 0.41 sec), borderline QTc (QTC =
0.42–0.44 sec), and prolonged QTc ( ≥ 0.45 sec) is being proposed to
improve the safety of administering antipsychotic drugs and to decrease
the risk of drug-related sudden death in psychiatric patients.

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