QT Interval, Antipsychotics and Correlates Among Patients with Schizophrenia: Cross-Sectional Data from the Multicentric Real-World FACE-SZ

Mona Gerentes, Mohamed Lajnef, Andrei Szöke, Bruno Aouizerate, Fabrice Berna, Maud Cléry, Isabelle Chéreau, Nathalie Coulon, Julia Clauss-Kobayashi, Eric Fakra, Jean-Michel Dorey, Caroline Dubertret, Guillaume Fond, Ophélia Godin, Tudi Goze, Christophe Lançon, Marion Leboyer, Sylvain Leignier, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Nicolas Oriol, Romain Rey, Paul Roux, Benoit Schorr, Mathieu Urbach, Etienne Véry, Franck Schürhoff and Baptiste Pignon ()
Additional contact information
Mona Gerentes: FondaMental Foundation
Mohamed Lajnef: FondaMental Foundation
Andrei Szöke: FondaMental Foundation
Bruno Aouizerate: FondaMental Foundation
Fabrice Berna: FondaMental Foundation
Maud Cléry: FondaMental Foundation
Isabelle Chéreau: FondaMental Foundation
Nathalie Coulon: FondaMental Foundation
Julia Clauss-Kobayashi: FondaMental Foundation
Eric Fakra: FondaMental Foundation
Jean-Michel Dorey: FondaMental Foundation
Caroline Dubertret: FondaMental Foundation
Guillaume Fond: FondaMental Foundation
Ophélia Godin: FondaMental Foundation
Tudi Goze: FondaMental Foundation
Christophe Lançon: FondaMental Foundation
Marion Leboyer: FondaMental Foundation
Sylvain Leignier: FondaMental Foundation
Pierre-Michel Llorca: FondaMental Foundation
Jasmina Mallet: FondaMental Foundation
David Misdrahi: FondaMental Foundation
Nicolas Oriol: FondaMental Foundation
Romain Rey: FondaMental Foundation
Paul Roux: FondaMental Foundation
Benoit Schorr: Toulouse University HospitalEquipe de Recherche sur les Rationalités Philosophiques et les Savoirs-EA3051, Université de Toulouse-Jean Jaurès
Mathieu Urbach: FondaMental Foundation
Etienne Véry: FondaMental Foundation
Franck Schürhoff: FondaMental Foundation
Baptiste Pignon: FondaMental Foundation

Drug Safety, 2025, vol. 48, issue 7, No 3, 739-752

Abstract: Abstract Background The life expectancy of patients with schizophrenia is reduced, partly due to cardiovascular diseases. Antipsychotics are associated with QT interval prolongation, which is a risk factor for arrhythmia and cardiac arrest. The differences between antipsychotic with regard to QT interval prolongation are not well understood. Objective The aim was to compare the QT values associated with different antipsychotics within a real-world population of subjects with clinically stable forms of schizophrenia. Methods The FACE-SZ cohort comprises subjects with psychotic disorders, referred to schizophrenia expert cents. QT interval was measured, as well as all treatments (psychotropic and others). The following maintenance treatment for schizophrenia was analysed cross-sectionally: aripiprazole, clozapine, haloperidol, amisulpride, olanzapine, quetiapine, risperidone. Age, sex, smoking status, body mass index, blood potassium levels, and the co-prescription of another QT-prolonging treatment were used as adjustment factors in multivariable linear regression analyses. Results Among 792 patients, the mean corrected QT (QTc) interval in the sample of patients under monotherapy was 407 ms. The mean age was 31.7 years, and the majority were male (73.3 %). In comparison to the rest of the sample, clozapine was associated with a longer QTc interval (β = 0.012, 95% CI [0.006–0.018]), while aripiprazole was significantly associated with a shorter QTc interval (β = − 0.010, 95% CI [− 0.016 to − 0.005]). Other antipsychotics were not associated with significant variations of the QTc. Conclusions The prescription of antipsychotics should always be accompanied by close monitoring of the QTc interval to prevent the risk of severe cardiac arrhythmia, particularly concerning clozapine.

Date: 2025
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DOI: 10.1007/s40264-025-01526-9

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