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- Title
Sudden Cardiac Death Associated with Long Acting Injectable Antipsychotics.
- Authors
Takahiko Nagamine
- Abstract
Background: Recently, sudden cardiac death (SCD) among patients treated with paliperidone palmitate caused a debate about using long-acting injectable antipsychotics (LAI). LAI are not well studied in view of SCD. Method: Reviewing the results of early post-marketing phase vigilance on LAI and estimating D2 receptor occupancy. Result: There are 2 findings; 1) administration of LAI to patients with physical risks possibly increases SCD, 2) four SCD cases among patients treated with paliperidone palmitate may be suspected to be due to ventricular arrhythmia. The estimated D2 receptor occupancy by single intramuscular paliperidone palmitate ISO mg was more than 80%. Conclusion: Even in patients without any serious physical complication, paliperidone palmitate may possibly increase the risk of ventricular arrhythmia, when higher dose is administered to unstable patients. In clinical practice, it is important to use LAI by following 5 points; 1) very careful use for patients with physical complication, 2) avoiding unnecessary high dose and very careful use for patients under polypharmacy, 3) avoiding LAI for patients with acute psychotic symptoms, 4) choosing LAI with lower risk of metabolic dysfunction and cardiovascular disorder, 5) monitoring for physical condition regularly and improving lifestyle.
- Subjects
ANTIPSYCHOTIC agents; CARDIAC arrest; DRUG side effects; INJECTIONS; PHARMACOLOGY; RESEARCH; MATHEMATICAL variables; CATECHOLAMINE receptors; POLYPHARMACY; VENTRICULAR arrhythmia
- Publication
International Medical Journal, 2016, Vol 23, Issue 3, p211
- ISSN
1341-2051
- Publication type
Article