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Heroin Addiction and Related Clinical Problems: 2009, 11, 4 (pages: 11 - 20)

Psychoactive Drugs and Prolongation of the QT Interval

Deruvo G., Vendramin A., Di Sciascio G.

Summary: The links between psychiatry and cardiology that are pertinent to potential cardiovascular risks associated with the use of psychotropic drugs, especially antipsychotics, cannot be viewed as entirely new. In Italy, however, an important innovation was made when, on 28 February 2007, the Italian Medicines Agency (AIFA), issued a directive laying down provisions for the amendment of the printed papers that accompany various medicines, including haloperidol; that initiative has revived the relevance of the whole question. In particular, contraindications to the use of these drugs have been redefined. The primary ones are now listed as acute myocardial infarction, decompensated heart failure, arrhythmias treated with antiarrhythmic drugs belonging to special classes, the prolongation of the QT interval corrected for heart rate (QTc), the family history for arrhythmia or torsades de pointes, hypokalaemia and the concomitant use of drugs that prolong the QTc.