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Role of Co-occurring Alcohol and Substances Abuse on QTc Interval Prolongation Among Psychiatric Patients: A Cross-sectional National Survey

Published online by Cambridge University Press:  23 March 2020

M. Corbo ,
T. Acciavatti ,
F. Fiori ,
R. Santacroce ,
A. Aguglia ,
F. Bartoli ,
S. Calò ,
M. Ribolsi ,
Y. Barone  and
F. Pinna
...Show all authors
M. Corbo
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
T. Acciavatti
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
F. Fiori
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
R. Santacroce
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
A. Aguglia
Affiliation:
University of Turin, Department of Neuroscience Rita Levi Montalcini, Turin, Italy
F. Bartoli
Affiliation:
University of Milano Bicocca, Department of Surgery and Interdisciplinary Medicine, Milan, Italy
S. Calò
Affiliation:
Azienda Sanitaria Locale Lecce, Dipartimento di Salute Mentale, Lecce, Italy
M. Ribolsi
Affiliation:
Università degli Studi di Roma Tor Vergata, Clinica Psichiatrica, Dipartimento di Medicina dei Sistemi, Roma, Italy
Y. Barone
Affiliation:
Università degli Studi di Roma Tor Vergata, Clinica Psichiatrica, Dipartimento di Medicina dei Sistemi, Roma, Italy
F. Pinna
Affiliation:
University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, Cagliari, Italy
M. Stilo
Affiliation:
Università degli Studi Magna Graecia, Unità Operativa Psichiatra, Dipartimento di Scienze della Salute, Catanzaro, Italy
P. Staffa
Affiliation:
Università degli Studi Magna Graecia, Unità Operativa Psichiatra, Dipartimento di Scienze della Salute, Catanzaro, Italy
M. Caroleo
Affiliation:
Università degli Studi Magna Graecia, Unità Operativa Psichiatra, Dipartimento di Scienze della Salute, Catanzaro, Italy
S. Ruberto
Affiliation:
Università degli Studi Magna Graecia, Unità Operativa Psichiatra, Dipartimento di Scienze della Salute, Catanzaro, Italy
M.S. Signorelli
Affiliation:
Università degli Studi di Catania, Clinica Psichiatrica, Dipartimento di Medicina Clinica e Sperimentale, Catania, Italy
F. Suraniti
Affiliation:
Università degli Studi di Catania, Clinica Psichiatrica, Dipartimento di Medicina Clinica e Sperimentale, Catania, Italy
D. Quattrone
Affiliation:
King's College, Institute of Psychiatry, Psychology and Neurosc, Londonu, United Kingdom
C. Reggianini
Affiliation:
Università degli studi di Modena e Reggio Emilia, Dipartimento di medicina diagnostica, clinica e di sanità pubblica, Modena, Italy
E. Carra
Affiliation:
Università degli studi di Modena e Reggio Emilia, Dipartimento di medicina diagnostica, clinica e di sanità pubblica, Modena, Italy
E. Gazzoletti
Affiliation:
Università degli studi di Modena e Reggio Emilia, Dipartimento di medicina diagnostica, clinica e di sanità pubbli, Modena, Italy
O. Campese
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
M. Castellazzi
Affiliation:
University of Verona, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Department of Public Health and Community Medicine, Verona, Italy
G. Ostuzzi
Affiliation:
University of Verona, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Department of Public Health and Community, Verona, Italy
I. Bighelli
Affiliation:
University of Verona, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Department of Public Health and Community Medicine, Verona, Italy
M. Nosè
Affiliation:
University of Verona, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Department of Public Health and Community Medicine, Verona, Italy
C. Barbui
Affiliation:
University of Verona, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Department of Public Health and Community Medicine, Verona, Italy
G. Martinotti
Affiliation:
University “G. D’ Annunzio” Chieti, Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy

Abstract

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Introduction

QTc interval prolongation is considered a risk factor for fatal polymorphic ventricular tachycardia, which can result in sudden cardiac death. Most psychotropic drugs have a dose-dependent potential to prolong the QTc interval. However, other factors require appropriate consideration, including: age; gender; other medications; electrolyte abnormalities; severe comorbid conditions, such as co-occurring alcohol or substances abuse/dependence.

Objectives

The objective was to study the potential mediating roles of alcohol/substances abuse on QTc prolongation.

Aims

The Italian research group STAR Network, in collaboration with the Young Italian Psychiatrists Association, aimed to evaluate the frequency of QTc interval prolongation in a sample of patients under treatment with psychotropic drugs through a cross-sectional national survey.

Methods

A sample of 2411 unselected patients were enrolled after performing an ECG during the recruitment period. Sociodemographic and clinical characteristics were collected from medical records. Collected data underwent statistical analysis.

Results

A total of 11.2% of patients reported alcohol abuse, and only 8.9% psychotropic substances. According to the threshold, less than 20% of patients had a borderline value of QTc, and 1% a pathological value. Patients with co-occurring alcohol misuse and drug abuse were more likely to have longer QTc interval.

Conclusions

The present study describes the frequency of QTc prolongation in real-world clinical practice. Before prescribing a psychotropic drug, the physician should carefully assess its risks and benefits to avoid this type of adverse reaction, particularly when additional risk factors are present. The potential role of alcohol and substances on QTc length could be particularly useful in emergency settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster walk: Substance related and addictive disorders–part 1
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S201 - S202
Copyright
Copyright © European Psychiatric Association 2017
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