Rezaei Bahareh, Javdani Hossein, Soleimannejad Maryam, Dodangeh Samira
Psychiatrist, Department of Psychiatry, Clinical Research Development Unit, 22 Bahman Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
Assistant Professor, Department of Psychiatry, Clinical Research Development Unit, 22 Bahman Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
ARYA Atheroscler. 2021 Jul;17(4):1-6. doi: 10.22122/arya.v17i0.2235.
Some types of antidepressants and antipsychotic medications have cardiovascular side effects that can be life-threatening. Electroconvulsive therapy (ECT) is capable of generating physiological stress and may lead to increased QT interval followed by arrhythmias. Risperidone can also increase the risk of arrhythmia by increasing the corrected QT (QTc) interval. Since many patients require co-administration of risperidone and ECT, this study aimed to investigate the concurrent effect of ECT and risperidone administration on the QTc interval.
For this cross-sectional study, 60 patients (18-65 years) admitted in 22 Bahman Psychiatric Hospital (Qazvin, Iran) that were candidate for treatment with risperidone, ECT, or both methods were concurrently divided into three groups. The groups included patients treated with ECT, risperidone, and combination treatment (risperidone and ECT). At the beginning of the study, electrocardiogram (ECG) was obtained for all patients and QT was performed manually, and finally, QTc interval was measured two times for each group. Required information was collected through medical records. Then, inferential statistics, analysis of variance (ANOVA), was used to determine differences between different variables.
A significant increase in heart rate (HR) in the third group compared to first and second groups was observed. None of the treatments had a significant effect on QTc interval, but the QTc interval increased slightly in groups treated with the ECT alone and particularly, the ECT plus risperidone in comparison to the baseline values.
Our study showed that risperidone, ECT, and their concomitant combination did not affect the QTc interval. Therefore, risperidone and ECT are safe and their combination can also be a good option for refractory patients undergoing ECG monitoring and cardiopulmonary devices.
某些类型的抗抑郁药和抗精神病药物具有可能危及生命的心血管副作用。电休克疗法（ECT）能够产生生理应激，并可能导致QT间期延长，继而引发心律失常。利培酮也可通过增加校正QT（QTc）间期来增加心律失常的风险。由于许多患者需要同时使用利培酮和ECT，本研究旨在调查ECT与利培酮联合使用对QTc间期的影响。
在这项横断面研究中，将伊朗加兹温市第22巴曼精神病医院收治的60例年龄在18至65岁之间、有使用利培酮、ECT或两种方法治疗指征的患者同时分为三组。这些组包括接受ECT治疗、利培酮治疗以及联合治疗（利培酮和ECT）的患者。研究开始时，为所有患者进行心电图（ECG）检查并手动测量QT，最后，对每组患者的QTc间期进行两次测量。所需信息通过病历收集。然后，使用推断统计学方法，即方差分析（ANOVA）来确定不同变量之间的差异。
观察到第三组的心率（HR）与第一组和第二组相比显著增加。没有一种治疗方法对QTc间期有显著影响，但与基线值相比，单独接受ECT治疗的组，特别是接受ECT加用利培酮治疗的组，QTc间期略有增加。
我们的研究表明，利培酮、ECT及其联合使用均不影响QTc间期。因此，利培酮和ECT是安全的，它们的联合使用对于接受心电图监测和心肺设备的难治性患者也可能是一个不错的选择。
