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Corrected QT Interval Prolongation in Psychopharmacological Treatment and Its Modulation by Genetic Variation
Filippo Corponi1, Chiara Fabbri1, Giuseppe Boriani2
1Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
Neuropsychobiology
|December 14, 2018
Summary
Genetic variants in ABCB1, NOS1AP, and KCNH2 genes may influence QTc prolongation in patients taking antipsychotics and antidepressants. This research aids in understanding genetic predispositions for personalized psychotropic medication use.
Area of Science:
- Pharmacogenetics
- Cardiology
- Psychiatry
Background:
- Antipsychotics and antidepressants can alter electrocardiogram (ECG) readings, notably prolonging the heart rate-corrected QT interval (QTc).
- QTc prolongation is a significant risk factor for sudden cardiac death.
- Genetic variations are known to influence an individual's response to these drugs, impacting QTc prolongation and offering potential for precision medicine.
Purpose of the Study:
- To investigate the effect of specific genetic variants on QTc prolongation in patients treated with psychotropic medications.
- To explore potential interactions between genetic polymorphisms and medication risk levels in determining QTc prolongation.
- To identify genetic markers associated with QTc duration changes during psychotropic drug treatment.
Main Methods:
- A sample of 77 patients with mood or psychotic disorders undergoing treatment with antidepressants and/or antipsychotics were analyzed.
- Electrocardiogram (ECG) recordings were used to measure QTc duration and assess the risk of QTc prolongation.
- Single-nucleotide polymorphisms (SNPs) previously linked to QTc prolongation were examined, along with medication risk classifications (high-to-moderate, low, no risk).
- A secondary analysis focused on QTc percentage change in 25 patients with two ECG recordings.
Main Results:
- No genetic associations with QTc prolongation survived multiple-testing correction.
- rs10808071 (ABCB1 gene) showed a nominal association with QTc duration when patients received at least one moderate-to-high risk medication (p = 0.007).
- rs12029454 (NOS1AP gene) was associated with QTc duration in patients taking at least one cardiovascular risk medication (p = 0.008).
- rs2072413 (KCNH2 gene) was the top finding for QTc percentage change in patients receiving a new moderate-to-high risk drug (p = 0.001).
Conclusions:
- Despite the study's limited statistical power, findings suggest that ABCB1, NOS1AP, and KCNH2 gene variants may influence QTc duration and prolongation.
- These results highlight the potential role of pharmacogenetics in managing psychotropic medication therapy and mitigating cardiac risks.
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