Potentially Arrhythmogenic Effects of Haloperidol and Olanzapine on Cardiac Autonomic Function-A Preliminary Study

目的：抗精神病藥物時有被報告與心臟毒性及不明原因的突然死亡案例有關。心臟自律神經功能失調或許造成服用抗精神藥物的精神分裂患者的心律不整。材料與方法：12位由門診招募，簡式精神症狀量表(BPRS)分數小於40分，症狀穩定的精神分裂症患者，分為兩組其中9位服用haloperidol，3位服用olanzapine參加本研究。每位患者於不同時間點接受心臟自律神經功能檢查。結果：本研究發現兩組在QTc延長方面無顯著差異，也沒有任何心臟自律神經功能檢查變項能夠預測抗精神病藥物的心律不整傾向。結論：自律神經功能檢查似乎並不適合使用於預測服用抗精神病藥物精神分裂症患者的心律不整傾向。未來需要有更多參與個案數目的研究來進一步證實此研究結果。

關鍵字

心臟自律神經功能；心律不整；精神分裂症；抗精神病藥物

並列摘要

Objective: Antipsychotic medications have been linked to instances of cardio-toxicity or unexplained sudden death. Dysfunction of the cardiac autonomic nervous system may be attributable to the adverse arrhythmic effects in schizophrenic patients taking antipsychotics. Materials and Methods: Twelve schizophrenic patients with scores for the Brief Psychiatry Rating Scale of less than 40, including nine haloperidol-treated patients and three olanzapine-treated patients, were recruited from the outpatient clinic. Each patient received comprehensive measurements of cardiac autonomic nervous function changes at two time points. The first assessment was done after discontinuing the antipsychotics and anticholinergics for more than two weeks. These patients then were prescribed the antipsychotic at the previous dosage again after this first assessment. The second assessment was performed six weeks later. Results: Our study found no statistically significant differences in QTc prolongation between the nine haloperidol-treated and the three olanzapine-treated patients. None of the variables for cardiac autonomic nervous function predicted any arrythymogenic potential of the antipsychotics in our study. Conclusions: Autonomic nervous variables do not seem to be suitable indices for arrythmogenic potential in medicated schizophrenic patients. Future studies involving larger samples are needed to confirm these results.

並列關鍵字

cardiac autonomic function ； arrhythmia ； schizophrenia ； antipsychotics

國際替代計量

Potentially Arrhythmogenic Effects of Haloperidol and Olanzapine on Cardiac Autonomic Function-A Preliminary Study

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