Top Paper of the Year: Second Generation Antipsychotics and Schizophrenia
Top Paper of the Year: Second Generation Antipsychotics and Schizophrenia
Second generation antipsychotics are now commonly prescribed worldwide for patients with schizophrenia. The agents in this class are known to have varying effects on the corrected QT interval, but the relative magnitude and risk posed by each agent has not been well studied. Because QT prolongation may be a marker of drug-related cardiac mortality, Chung and Chua1 recently published a meta-analysis in the Journal of Psychopharmacology that compares the effects and relative risk of the most commonly prescribed of these agents.
Dr David Osser, a member of the editorial board of Psychiatric Times, has chosen this meta-analysis as one of the "Top Papers of the Year," and in the next few minutes, he will be discussing the clinical highlights....and what they might mean for your practice. Dr. Osser is associate professor of psychiatry at Harvard Medical School at the Brockton VA Medical Center and Taunton State Hospital.
Dr Osser has no conflicts of interest, and nothing to disclose regarding any financial relationships with any pharmaceutical firms.
| Dr Osser's Top Paper of the Year: Second Generation Antipsychotics and Schizophrenia | |
Dr Osser's Top Paper of the Year: Second Generation Antipsychotics and Schizophrenia | |
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Read the abstract of the original Journal of Psychopharmacology article here:
Effects on Prolongation of Bazett's Corrected QT Interval of Seven Second-Generation Antipsychotics in the Treatment of Schizophrenia: A Meta-Analysis
I think it was an excellent summary of the article, but I don't think QT prolongation( and especially the minor differences in QT prolongation between the anti-psychotics) is as relevant as you present it.
I hardly think that this meta-analysis, which is merely a statistical review of existing studies (not really a study) warrants this kind of attention. The problem with all meta-analyses (some are better than others) is that sources of bias are not controlled. So a good meta-analysis of badly designed studies will still result in bad statistics.
A number of years ago, we encountered a situation where a family member developed cardiac irrgularity during a hospital stay for an accute episode, (partial Left Bundle branch block & Prolonged QT.) We suspect that he had been given Haldol with out an order & which not documented, ( got copies of records on discharge.) EKG was normal a number of months later when on Resperidone at home. Abilify & Serequel exacerbated the illness to the worst hallulcinations. Darrel's Mom
refusal to provide the requested data. --Best, Ron Pies MD