QTc interval lengthening in first-episode schizophrenia (FES) patients in the earliest stages of antipsychotic treatment

Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4 weeks) of antipsychotic treatments, compared with baseline. After about 2 or 4 weeks of antipsychotic use, the risk of abnormal QTc prolongation was higher than at baseline. These results reinforce the importance of monitoring risk factors and assessing QTc prolongation at the beginning and throughout treatment with antipsychotics.