Schwerthöffer Dirk, Förstl Hans, Fatke Bastian
Klinikum rechts der Isar, Klinik für Psychiatrie und Psychotherapie, Schlafmedizinisches Zentrum, 81675, München, Deutschland.
MMW Fortschr Med. 2019 Jul;161(Suppl 5):1-6. doi: 10.1007/s15006-019-0743-x. Epub 2019 Jul 16.
QTc prolongation is a common and serious side effect of antipsychotics in the treatment of delirium. Nevertheless, the occurrence of ventricular tachycardia is rarely reported, so that the clinical relevance of a QTc prolongation triggered in this way remains unclear.
The focus of this review is on the antipsychotic pharmacotherapy of delirium.
In individual cases, before the prescription of an antipsychotic due to a delirium, a risk-benefit assessment must be made for the patient. For this purpose, patient and substance-specific risk factors for QTc prolongation must be checked and, if possible, reduced. A specific recommendation for an antipsychotic with assured low QTc interference can not be given because all antipsychotics for delirium treatment are potentially QTc-prolonging. Antipsychotic delirium treatment should be monitored, especially in patients with a high risk profile, for QTc prolongation by regular ECG controls.
在谵妄治疗中，QTc间期延长是抗精神病药物常见且严重的副作用。然而，室性心动过速的发生鲜有报道，因此以这种方式引发的QTc间期延长的临床相关性仍不明确。
本综述的重点是谵妄的抗精神病药物治疗。
在个别病例中，因谵妄开具抗精神病药物处方前，必须对患者进行风险效益评估。为此，必须检查患者和药物特异性的QTc间期延长风险因素，并尽可能降低风险。由于所有用于治疗谵妄的抗精神病药物都有潜在的QTc间期延长作用，因此无法给出关于具有确定低QTc干扰作用的抗精神病药物的具体推荐。抗精神病药物治疗谵妄时应进行监测，尤其是高危患者，通过定期心电图检查监测QTc间期延长情况。
