Effects of psychotropic medications on electrocardiography

Abstract

Background and aim: In recent years number of psychiatric patients has increased and psychotropic medications are becoming mostly used drugs. These drugs may affect cardiovascular system and we can check side effects with electrocardiography (ECG). In this study we aimed to analyse psychiatric medications' side effects on ECG. Objective and methods: Eighty-five patients included in this study have psychiatric diagnosis and have used psychoactive medications. Forty-five of these patients are male and 40 of them are female. Age varies from 23 to 94 years. ECG has been taken from the patients and PR duration, QRS duration, and corrected QT measured from each ECG. Twenty-two kinds of drugs (Akineton, Haldol, Zyprexia, Prolixin, Dogmatil, Risperdal, Diazem, Artane, Tegretol, Sulpirid, Cipram, Seroquel, Depaqin, Stelazin, Anafranil, Rivotril, Clopiksol, Largactil, Melleril, Epanutin, Nurodol, Desyrel) were analyzed statistically and PR duration, QRS duration, and cQT checked if there is an association with these drugs. Results: All statistical analysis was performed with the IBM SPSS software package (version 24.0, IBM, Armong, NY, USA) at the 95% confi dence interval level and p <0.05 level of signifi cance. Quantitative variables were analyzed by Friedman analysis for dependent group. Moreover the independent groups were compared with Mann–Whitney U test. In this study with univariate analyses we found that Haldol, Epanutin and Nurodol may cause long PR, risperdal, Seroquel, clopiksol, and Nurodol may cause long QRS duration, depakin, stelazin, Melleril, Nurodol may cause long QT. On the other hand with multivariate analyses Tegretol is associated with QRS duration at a level of significance of 0.05 (p = 0.044). Diazem is effective for increasing the PR duration at a level of significance of 0.05 (p = 0.037) and Desyrel is effective for increasing the QTC time at a significance level of 0.05 (p = 0.023). Conclusion: In this study we showed that among psychoactive medications, Nurodol is the most related drug that affects ECG and may cause long PR, long QRS duration and long QT. So while using psychiatric tablets physicians, nurses, families should be aware of cardiovascular side effects and regular ECG controls should be checked