Effects of Medication and Pathophysiology on 12-lead Electrocardiograms in Bipolar Disorder and Schizophrenia

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Abstract

Background: Cardiovascular disease is the principal cause of death among patients with bipolar disorder and schizophrenia. We hypothesized that a combination of psychophysiology and the use of lithium, along with antipsychotics, alter electrocardiophysiological activity in bipolar and schizophrenic patients. Purpose: The goal of this study was to evaluate the effects of psychotropic agents and the pathophysiology using 12-lead electrocardiograms (EKGs) in bipolar and schizophrenic patients. Methods: The study involved three groups of patients: (1) 30 lithium/haloperidol-treated patients with bipolar mania (15 males, 15 females); (2) 33 lithium-free patients with bipolar mania (21 males, 12 females); and (3) 31 lithium-free schizophrenic patients (15 males, 16 females). Clinical data were obtained through a retrospective review of the medical records of all subjects. Results: The mean PQ interval, QRS complex, and corrected QT (QTc) intervals did not differ among the three groups. Among those in the lithium/haloperidol-treated bipolar mania group, the QTc interval demonstrated a marginally significant correlation with serum lithium levels (r = 0.373; p = 0.05). Conclusion: Pathophysiological changes or minor abnormalities of electrocardiophysiological activity in schizophrenia and bipolar disorder patients might not be displayed by routine 12-lead EKGs. Because of the limitations of 12-lead EKGs, bipolar manic patients who have higher serum lithium levels might have increased risks for QTc prolongation, and thus QTc intervals should be carefully followed-up in these patients.

Original languageEnglish
Pages (from-to)181-185
Number of pages5
JournalJournal of Experimental and Clinical Medicine(Taiwan)
Volume2
Issue number4
DOIs
Publication statusPublished - Aug 2010

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Bipolar Disorder
Schizophrenia
Electrocardiography
Lithium
Haloperidol
Lead
Psychophysiology
Serum
Antipsychotic Agents
Medical Records
Cause of Death
Cardiovascular Diseases

Keywords

  • Bipolar mania
  • Electrocardiography
  • Lithium
  • QTc interval
  • Schizophrenia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Effects of Medication and Pathophysiology on 12-lead Electrocardiograms in Bipolar Disorder and Schizophrenia",
abstract = "Background: Cardiovascular disease is the principal cause of death among patients with bipolar disorder and schizophrenia. We hypothesized that a combination of psychophysiology and the use of lithium, along with antipsychotics, alter electrocardiophysiological activity in bipolar and schizophrenic patients. Purpose: The goal of this study was to evaluate the effects of psychotropic agents and the pathophysiology using 12-lead electrocardiograms (EKGs) in bipolar and schizophrenic patients. Methods: The study involved three groups of patients: (1) 30 lithium/haloperidol-treated patients with bipolar mania (15 males, 15 females); (2) 33 lithium-free patients with bipolar mania (21 males, 12 females); and (3) 31 lithium-free schizophrenic patients (15 males, 16 females). Clinical data were obtained through a retrospective review of the medical records of all subjects. Results: The mean PQ interval, QRS complex, and corrected QT (QTc) intervals did not differ among the three groups. Among those in the lithium/haloperidol-treated bipolar mania group, the QTc interval demonstrated a marginally significant correlation with serum lithium levels (r = 0.373; p = 0.05). Conclusion: Pathophysiological changes or minor abnormalities of electrocardiophysiological activity in schizophrenia and bipolar disorder patients might not be displayed by routine 12-lead EKGs. Because of the limitations of 12-lead EKGs, bipolar manic patients who have higher serum lithium levels might have increased risks for QTc prolongation, and thus QTc intervals should be carefully followed-up in these patients.",
keywords = "Bipolar mania, Electrocardiography, Lithium, QTc interval, Schizophrenia",
author = "Chen, {Pao Huan} and Tsai, {Shang Ying} and Chung, {Kuo Hsuan}",
year = "2010",
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doi = "10.1016/S1878-3317(10)60028-9",
language = "English",
volume = "2",
pages = "181--185",
journal = "Journal of Experimental and Clinical Medicine",
issn = "1878-3317",
publisher = "Elsevier Taiwan LLC",
number = "4",

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TY - JOUR

T1 - Effects of Medication and Pathophysiology on 12-lead Electrocardiograms in Bipolar Disorder and Schizophrenia

AU - Chen, Pao Huan

AU - Tsai, Shang Ying

AU - Chung, Kuo Hsuan

PY - 2010/8

Y1 - 2010/8

N2 - Background: Cardiovascular disease is the principal cause of death among patients with bipolar disorder and schizophrenia. We hypothesized that a combination of psychophysiology and the use of lithium, along with antipsychotics, alter electrocardiophysiological activity in bipolar and schizophrenic patients. Purpose: The goal of this study was to evaluate the effects of psychotropic agents and the pathophysiology using 12-lead electrocardiograms (EKGs) in bipolar and schizophrenic patients. Methods: The study involved three groups of patients: (1) 30 lithium/haloperidol-treated patients with bipolar mania (15 males, 15 females); (2) 33 lithium-free patients with bipolar mania (21 males, 12 females); and (3) 31 lithium-free schizophrenic patients (15 males, 16 females). Clinical data were obtained through a retrospective review of the medical records of all subjects. Results: The mean PQ interval, QRS complex, and corrected QT (QTc) intervals did not differ among the three groups. Among those in the lithium/haloperidol-treated bipolar mania group, the QTc interval demonstrated a marginally significant correlation with serum lithium levels (r = 0.373; p = 0.05). Conclusion: Pathophysiological changes or minor abnormalities of electrocardiophysiological activity in schizophrenia and bipolar disorder patients might not be displayed by routine 12-lead EKGs. Because of the limitations of 12-lead EKGs, bipolar manic patients who have higher serum lithium levels might have increased risks for QTc prolongation, and thus QTc intervals should be carefully followed-up in these patients.

AB - Background: Cardiovascular disease is the principal cause of death among patients with bipolar disorder and schizophrenia. We hypothesized that a combination of psychophysiology and the use of lithium, along with antipsychotics, alter electrocardiophysiological activity in bipolar and schizophrenic patients. Purpose: The goal of this study was to evaluate the effects of psychotropic agents and the pathophysiology using 12-lead electrocardiograms (EKGs) in bipolar and schizophrenic patients. Methods: The study involved three groups of patients: (1) 30 lithium/haloperidol-treated patients with bipolar mania (15 males, 15 females); (2) 33 lithium-free patients with bipolar mania (21 males, 12 females); and (3) 31 lithium-free schizophrenic patients (15 males, 16 females). Clinical data were obtained through a retrospective review of the medical records of all subjects. Results: The mean PQ interval, QRS complex, and corrected QT (QTc) intervals did not differ among the three groups. Among those in the lithium/haloperidol-treated bipolar mania group, the QTc interval demonstrated a marginally significant correlation with serum lithium levels (r = 0.373; p = 0.05). Conclusion: Pathophysiological changes or minor abnormalities of electrocardiophysiological activity in schizophrenia and bipolar disorder patients might not be displayed by routine 12-lead EKGs. Because of the limitations of 12-lead EKGs, bipolar manic patients who have higher serum lithium levels might have increased risks for QTc prolongation, and thus QTc intervals should be carefully followed-up in these patients.

KW - Bipolar mania

KW - Electrocardiography

KW - Lithium

KW - QTc interval

KW - Schizophrenia

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