Early Corrected QT Interval Changes Following First-dose Long-acting Injectable Antipsychotics: A Retrospective Inpatient Study
Clinical Psychopharmacology and Neuroscience, cilt.24, sa.3, ss.547-557, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 24 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.9758/cpn.25.1374
- Dergi Adı: Clinical Psychopharmacology and Neuroscience
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Psycinfo, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.547-557
- Anahtar Kelimeler: Antipsychotic agents, Delayed-action preparations, Electrocardiography, QTc prolongation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Long-acting injectable (LAI) antipsychotics improve adherence and reduce relapse, yet short-term cardiac effects during the initial dosing window remain insufficiently characterized. We examined early corrected QT (QTc) changes within 7−14 days after first LAI dose in psychiatric inpatients and tested whether changes vary by LAI type and common clinical modifiers. Methods: We conducted a retrospective chart review of psychiatric inpatients who received their first LAI antipsychotic during admission. Electrocardiograms (ECG) obtained before LAI initiation and again 7−14 days after injection were analyzed. QTc intervals were calculated using Bazett’s formula. The primary outcome was the within-patient QTc change (∆QTc). Prespecified subgroup analyses examined differences across clinical subgroups. Results: Sixty-three patients had paired ECG recordings. Baseline QTc values were comparable across subgroups. Overall, QTc change after LAI injection was small and not statistically significant (418.7 ± 22.8 ms vs. 421.0 ± 25.0 ms; p = 0.323), and no patient exceeded QTc ≥ 500 ms. Modest QTc increases were observed with second-generation LAIs (p = 0.008), particularly paliperidone palmitate (p = 0.046), as well as with concomitant anticholinergic use (p = 0.024) and medical comorbidity (p = 0.034); however, absolute changes remained ＜ 10 ms. In regression analysis (R2 = 0.565), baseline QTc was the only independent predictor of post-injection QTc (β = 0.687, p ＜ 0.001). Conclusion: Early QTc changes after LAI initiation were small and not clinically meaningful. Post-injection QTc was mainly determined by baseline QTc, supporting guideline-concordant ECG monitoring without routine intensified cardiac surveillance in low-risk patients.