Association of Antipsychotics with QTc Prolongation and Torsades de Pointes

Association of Antipsychotics with QTc Prolongation and Torsades de Pointes

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45 year old male with with history of schizophrenia is admitted with worsening of psychotic symptoms. During evaluation EKG reveals QTc  of 470 msec. 

Q: Which antipsychotics are associated with QTc prolongation

Q: Which antipsychotics are associated with risk of Torsades de Pointes?

 

Medications Association with QTc Prolongation Association with Torsades de Pointes
HIGH RISK
Thioridazine +++ +++
Haloperidol (IV) +++ +++
Ziprasidone +++ +
MODERATE RISK
Haloperidol (PO/IM) ++ ++
Fluphenazine ++
Paliperidone ++
Iloperidone ++
Risperidone + +
LOW RISK
Olanzapine + +
Quetiapine + +
Lurasidone +
Asenapine +
MINIMAL RISK
Aripiprazole

 

SourcePsychosomatics 2013; 54:1–13

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Dr. Harvinder Singh, M.D. (Admin)


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