Psychopharmacology

, Volume 216, Issue 1, pp 9–16 | Cite as

Sex difference in QTc prolongation in chronic institutionalized patients with schizophrenia on long-term treatment with typical and atypical antipsychotics

  • Fu De Yang
  • Xiang Qun Wang
  • Xiu Ping Liu
  • Ke Xin Zhao
  • Wei Hong Fu
  • Xue Ru Hao
  • Xing Li Zhang
  • Guo Shu Huang
  • Sheng Cai Qu
  • Jing Shen Bai
  • Xu Feng Huang
  • Thomas R. Kosten
  • Xiang Yang Zhang
Original Investigation

Abstract

Objective

The rate-corrected electrocardiographic QT (QTc) interval may significantly increase in patients with schizophrenia taking antipsychotics. The objective of this naturalistic study was to assess the prevalence of prolonged QTc interval in a large population of inpatients with chronic schizophrenia and to explore QTc relationship with demographic variables and prescribed treatments.

Materials and methods

Electrocardiograms were obtained from age- and sex-matched 456 controls and 1,006 inpatients with schizophrenia (male/female = 689/317) taking antipsychotics. QTc prolongation was defined as a mean value of two standard deviations above the controls. The adjusted relative risk was calculated using logistic regression analysis.

Results

QTc prolongation was present in 45 (4.5%) of 1,006 patients overall. Fewer men (3.2%, 22 of 689) than women (7.3%, 23 of 317) displayed QTc prolongation (p < 0.004). Moreover, QTc intervals were shorter in male (391 ± 31 ms) than female subjects (400 ± 37 ms) (p < 0.001). Clozapine was found to produce a longer QTc intervals compared to risperidone and typical antipsychotics. Furthermore, multiple regression analysis showed that significant predictors for QTc prolongation were comorbid cardiovascular disease, antipsychotic types, sex, and age (all p < 0.01).

Conclusion

Our present findings suggest that there are sex differences in the prevalence of QTc prolongation and QTc lengthening in schizophrenia. Antipsychotic types are risk factors for QTc prolongation, and risks are substantially higher for clozapine.

Keywords

Schizophrenia Antipsychotics QT prolongation Electrocardiography 

Notes

Acknowledgments

This study was funded by the Stanley Medical Research Institute (03T-459 and 05T-726) and the United States National Institute of Health (K05-DA0454, P50-DA18827, and U01-MH79639).

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Fu De Yang
    • 1
  • Xiang Qun Wang
    • 1
  • Xiu Ping Liu
    • 1
  • Ke Xin Zhao
    • 1
  • Wei Hong Fu
    • 1
  • Xue Ru Hao
    • 1
  • Xing Li Zhang
    • 1
  • Guo Shu Huang
    • 1
  • Sheng Cai Qu
    • 1
  • Jing Shen Bai
    • 1
  • Xu Feng Huang
    • 2
  • Thomas R. Kosten
    • 3
    • 4
  • Xiang Yang Zhang
    • 3
    • 5
  1. 1.Beijing HuiLongGuan HospitalBeijingPeople’s Republic of China
  2. 2.Centre for Translational Neuroscience, School of Health SciencesUniversity of WollongongWollongongAustralia
  3. 3.Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonUSA
  4. 4.VA Medical CenterHoustonUSA
  5. 5.VA Medical CenterHoustonUSA

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