精神病患者におけるQTc間隔異常と精神薬療法
J G Reilly1, S A Ayis, I N Ferrier
1Academic Department of Psychiatry, University of Newcastle Upon Tyne, UK.
Lancet (London, England)
|April 1, 2000
まとめ
特定の抗精神病薬を服用している精神病患者は,危険な心拍のマーカーであるQTc延長のリスクが高い. 投与量は重要で,より高い投与量は薬物誘発性心拍不全のリスクを高めます.
科学分野:
- 心臓病学 心臓病学
- 精神科医は精神病を患っている.
- 薬理学 薬理学とは
背景:
- 精神病患者の突然の原因不明の死亡は,懸念事項です.
- QT 間隔の延長によって示される薬剤誘発性心拍動不良は,潜在的な原因である.
- 速度修正QTインターバル (QTc) は心律不良の予測マーカーです.
研究 の 目的:
- 精神病患者のQTc延長の流行を推定する.
- 様々な精神薬がQTc間隔に与える影響を評価する.
主な方法:
- 495人の精神病患者と101人の健康な対照群の心電図を分析した.
- ECG分析には検証されたデジタル化技術が使用されました.
- ロジスティック回帰は,QTc延長とT波異常の予測要因を特定しました.
主要な成果:
- 異常なQTc (>456 ms) は,精神病患者の8%で発見されました.
- QTc延長の予測要因には,65歳以上の年齢,三環抗うつ薬,チオリダジン,ドロペリドール,抗精神病薬の投与量などが含まれています.
- リチウム療法は,抗精神病薬とは異なり,QT分散およびT波異常と関連していました.
結論:
- 抗精神病薬は,QTcの延長を投与量に依存した方法で引き起こします.
- ティオリダジンとドロペリドールは,QTc延長のリスクを大幅に高めています.
- これらの発見は,特定の抗精神病薬の使用と関連した薬物誘発性心拍不全のリスクの増加を示唆しています.
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