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Haloperidol-induced torsades de pointes
M Kriwisky1, G Y Perry, D Tarchitsky
1Heart Institute, Edith Wolfson Medical Center, Holon, Israel.
Chest
|August 1, 1990
Summary
Psychotherapy with haloperidol can cause dangerous heart rhythms like torsades de pointes ventricular tachycardia. Stopping the drug and using isoproterenol reversed these effects, aiding understanding of sudden cardiac death risks.
Area of Science:
- Cardiology
- Psychopharmacology
- Clinical Medicine
Background:
- Haloperidol, an antipsychotic medication, is sometimes used in psychotherapy.
- QT interval prolongation is a known risk factor for cardiac arrhythmias.
- Torsades de pointes ventricular tachycardia is a life-threatening arrhythmia associated with QT prolongation.
Observation:
- A patient undergoing psychotherapy experienced torsades de pointes ventricular tachycardia.
- This event was temporally associated with the administration of conventional doses of haloperidol.
- The patient's QT interval was significantly prolonged during the event.
Findings:
- Cessation of haloperidol led to QT interval shortening.
- Infusion of isoproterenol further facilitated QT interval normalization.
- Torsades de pointes bursts resolved concurrently with QT interval shortening.
Implications:
- This case highlights a potential mechanism linking haloperidol-induced QT prolongation to torsades de pointes.
- Understanding this mechanism may inform risk assessment and management strategies for patients on haloperidol.
- The findings contribute to the broader understanding of sudden cardiac death in patients receiving pharmacologic psychotherapy.