Electrocardiographic Changes During Initiation of Lithium Augmentation of Antidepressant Pharmacotherapy
| Autor: | Christoph Richter, Thomas Stamm, Bruno Steinacher, Sarah Luise Osterland, Jeanette Schulz-Menger, Roland Ricken, Walter de Millas, Tom Bschor, Josephine Kermer, Peter Schlattmann, Süleyman Bilal, Pichit Buspavanich, Andreas Heinz, Mazda Adli, Joachim Behr, Grace O'Malley, M. Berger |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Lithium (medication) Heart Diseases QT interval QRS complex Depressive Disorder Treatment-Resistant Electrocardiography Internal medicine Heart rate medicine ST segment Humans Pharmacology (medical) cardiovascular diseases Adverse effect Depressive Disorder Major business.industry Drug Synergism Middle Aged medicine.disease Antidepressive Agents Psychiatry and Mental health Cardiology Lithium Compounds Major depressive disorder Antidepressant Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Journal of clinical psychopharmacology. 42(1) |
| ISSN: | 1533-712X |
| Popis: | PURPOSE/BACKGROUND Lithium augmentation of antidepressants represents a common strategy to overcome treatment resistance in patients with major depressive disorder. The use of lithium has been associated with cardiovascular adverse effects such as QTc prolongation and tachyarrhythmia. Although the previous studies investigated monotherapy with lithium, the aim of this study was to investigate electrocardiographic changes in LA. METHODS/PROCEDURES A 12-lead surface electrocardiogram (ECG) was obtained from 38 patients with major depressive disorder before and during LA. Changes in heart rate, PQ, QRS and QTc interval, QT dispersion, ST segment, and T- and U-wave alterations were analyzed using a linear mixed model. FINDINGS/RESULTS The ECG readings of 33 patients were evaluated. Lithium augmentation was not significantly associated with changes in heart rate, QTc, PQ, or QRS interval. We found a significant decrease in QT dispersion. These results were independent of sex, age, stable comedication, and comorbidities. During LA, we observed 9 cases of T-wave alterations and 2 cases of new U waves. CONCLUSIONS Our data provide no evidence for serious ECG abnormalities at therapeutic serum lithium levels in patients treated with LA. In particular, we did not find evidence for QTc time lengthening or tachyarrhythmia, such as torsades des pointes. The recommended intervals for ECG checks should be considered to detect long-term effects of LA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|