- Title
- Prediction of torsade de pointes from the QT interval: analysis of a case series of amisulpride overdoses
- Creator
- Joy, J. P.; Coulter, C. V.; Duffull, S. B.; Isbister, G. K.
- Relation
- Clinical Pharmacology & Therapeutics Vol. 90, Issue 2, p. 243-245
- Publisher Link
- http://dx.doi.org/10.1038/clpt.2011.107
- Publisher
- Nature Publishing Group
- Resource Type
- journal article
- Date
- 2011
- Description
- Electrocardiograms (ECGs) from a case series of 86 amisulpride overdose events in 66 patients were reviewed for abnormal QT intervals and torsade de pointes (TdP). Eight patients exhibited TdP. In this investigative case series, the magnitude of prolongation of the QT interval was a stronger predictor of TdP than the mere presence of a prolongation per se. Torsade de pointes (TdP) is a potentially fatal ventricular arrhythmia that can be associated with drug-induced prolongation of the QT interval.1 Despite the availability of numerous methods for assessing the risk of TdP on the basis of the presence of QT prolongation,2-5few studies have investigated the direct relationship between the magnitude of QT prolongation and the risk of TdP. Previous studies have generally considered the presence or absence of QT prolongation as a marker of the potential risk for TdP. In addition, they investigated data arising from a range of different drugs, with differing intrinsic cardiotoxic effects. This carries the potential for confounding of the relationship between the magnitude of prolongation of the QT interval and the inherent cardiotoxicity of the drug. Amisulpride is an atypical antipsychotic drug used to treat both the positive and negative symptoms of schizophrenia. It has affinity for limbic D2 and D3 receptors and only slight affinity for serotonergic, cholinergic, adrenergic, and histaminergic receptors.6 An overdose of the drug has been reported to cause QT prolongation and TdP.7 The aim of this study was to investigate whether the magnitude of QT prolongation is a better predictor of TdP than either the occurrence of QT prolongation per se or the dose of the drug. This was investigated in a case series of drug overdose events involving amisulpride.
- Subject
- electrocardiograms; amisulpride overdoses; QT intervals; torsade de pointes
- Identifier
- http://hdl.handle.net/1959.13/1044793
- Identifier
- uon:14378
- Identifier
- ISSN:0009-9236
- Language
- eng
- Reviewed
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