Effect of antipsychotic use by patients with schizophrenia on deceleration capacity and its relation to the corrected
Hiroaki Okayasu1, Takahiro Shinozaki1, Yumiko Takano1
1Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan.
Insights
Antipsychotic use in schizophrenia patients is linked to reduced heart rate deceleration capacity (DC), a predictor of cardiac death. Monitoring DC may help identify at-risk patients.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Schizophrenia patients on antipsychotics face increased sudden cardiac death risk.
- Deceleration capacity (DC) of heart rate predicts cardiac mortality.
- Antipsychotic medications can affect cardiac function.
Purpose of the Study:
- To evaluate sudden cardiac death risk in schizophrenia patients treated with antipsychotics.
- To assess heart rate deceleration capacity (DC) in these patients.
- To examine the association between DC and corrected QT interval (QTc).
Main Methods:
- Measured DC and QTc in 138 schizophrenia patients.
- Compared DC between patients and 86 healthy controls.
- Analyzed DC correlation with antipsychotic dose and QTc in patients.
Main Results:
- Schizophrenia patients on antipsychotics showed significantly lower DC than controls.
- DC negatively correlated with antipsychotic dose (chlorpromazine, zotepine, olanzapine, clozapine).
- No significant association found between DC and QTc.
Conclusions:
- Assessing DC can help monitor and identify cardiac mortality risk in schizophrenia patients on antipsychotics.
- Combined assessment of DC and QTc may improve sudden cardiac death prediction.
Objective:
Schizophrenia patients treated with antipsychotics are at higher risk of sudden cardiac death. Decreased deceleration capacity (DC) of the heart rate is an accurate predictor of cardiac mortality. We evaluated the risk of sudden cardiac death due to antipsychotic use by assessing DC and examining the association between DC and the corrected QT interval (QTc) in schizophrenia patients.
Methods:
We measured the DC and QTc of 138 schizophrenia patients. We then compared the DC of 86 age- and sex-matched healthy controls with that of 86 schizophrenia patients. We investigated the correlation of DC of approximately 138 schizophrenia patients with prescribed doses of antipsychotics using linear regression analysis. We compared the DC of schizophrenia patients with and without prolonged QT intervals.
Results:
We found DC significantly differed between schizophrenia patients on antipsychotic medication and healthy controls. Additionally, DC was negatively correlated with antipsychotic use, especially chlorpromazine, zotepine, olanzapine and clozapine, in a dose-dependent manner. There was no significant association between DC and the QTc.
Conclusion:
Assessing DC could facilitate monitoring and identification of increased risk of cardiac mortality in patients with schizophrenia that take antipsychotics. Assessing both DC and the QTc may enhance the accuracy of predicting sudden cardiac death.
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