Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
Department of Pharmacology, All India Institute of Medical Sciences, Kalyani, India.
J Pharm Pract. 2024 Feb;37(1):162-168. doi: 10.1177/08971900221121371. Epub 2022 Aug 14.
Drug-drug interactions (DDIs) are considered an emerging threat to the patients if undetected. DDIs can prolong QT interval, leading to fatal ventricular arrhythmia. Antipsychotics and antidepressants prescribed commonly to psychiatric patients have the propensity to prolong QT interval and can precipitate Torsades de pointes (TdP). This review aimed to summarize the prevalence of QT interval prolonging DDIs in psychiatric patients. This meta-analysis was carried out following the MOOSE (Meta-analysis of Observational Studies in Epidemiology) statement. Databases like Pubmed/MEDLINE, Google Scholar and Research gate were scanned for English language papers. Indexed terms from Medical Subject (MeSH) and other search terms for "QT prolongation", "Drug interactions", and "Psychiatry" were used to identify the articles. All published articles available until the day of the collection were considered. Outcome measures were analyzed with meta package in R language. A total of 5 studies were eligible for inclusion. From the included studies, QT-prolonging DDIs were found in 14806 patients out of 30122 patients. The prevalence of QT-prolonging DDIs in psychiatric patients was found to be 42% (95% confidence interval: 21%, 66%). The factors associated with potential drug-drug interactions were related to patient characteristics such as polypharmacy, age and comorbid disease. This review concluded that psychiatric patients were prescribed the drugs/drug combinations which can prolong QT interval and can cause adverse effects on the cardiovascular system. Hence, it is important to implement precautionary safety interventions, be vigilant and prevent QT prolongation and adverse cardiac effects in clinical practice.
药物-药物相互作用（DDI）如果未被发现，被认为是对患者的一个新出现的威胁。DDI 可延长 QT 间期，导致致命性室性心律失常。常用于精神科患者的抗精神病药和抗抑郁药有延长 QT 间期的倾向，并可能引发尖端扭转型室性心动过速（TdP）。本综述旨在总结精神科患者中 QT 间期延长的 DDI 的发生率。 这项荟萃分析是根据 MOOSE（观察性研究的荟萃分析流行病学）声明进行的。扫描了 Pubmed/MEDLINE、Google Scholar 和 Research gate 等数据库，以获取英语论文。使用医学主题词（MeSH）索引项和其他搜索词“QT 延长”、“药物相互作用”和“精神病学”来识别文章。考虑了截至收集日当天发表的所有可用文章。使用 R 语言中的 meta 包分析结果。 共有 5 项研究符合纳入标准。在纳入的研究中，在 30122 名患者中有 14806 名患者发生了 QT 延长的 DDI。精神科患者中 QT 延长的 DDI 发生率为 42%（95%置信区间：21%，66%）。与潜在药物-药物相互作用相关的因素与患者特征有关，如多药治疗、年龄和合并症。 本综述得出结论，精神科患者开的药物/药物组合可延长 QT 间期，并可能对心血管系统产生不良影响。因此，在临床实践中实施预防性安全干预措施、保持警惕、预防 QT 延长和不良心脏影响非常重要。
