human psychopharmacology

Hum. Psychopharmacol Clin Exp 2015; 30: 9499

Published online 22 January 2015 in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/hup.2458

QTc prolongation in schizophrenia patients in Asia: clinical correlates

and trends between 2004 and 2008/2009
Yu-Tao Xiang1,2*, Helen F. K. Chiu2, Gabor S. Ungvari3, Christoph U. Correll4, Kelly Y. C. Lai2, Chuan-Yue
Wang5, Tian-Mei Si6, Edwin H. M. Lee7, Yan-Ling He8, Shu-Yu Yang9, Mian-Yoon Chong10, Ee-Heok Kua11,
Senta Fujii12, Kang Sim13, Michael K. H. Yong13, Jitendra K. Trivedi14, Eun-Kee Chung15, Pichet Udomratn16,
Kok-Yoon Chee17, Norman Sartorius18, Chay-Hoon Tan19 and Naotaka Shinfuku20
1

Faculty of Health Sciences, University of Macau, Macao, Special Administrative Region, China
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
3
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
4
Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York, USA
5
Beijing Anding Hospital, Capital Medical University, Beijing, China
6
Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China
7
Department of Psychiatry, University of Hong Kong, Hong Kong, Special Administrative Region, China
8
Shanghai Mental Health Center, Shanghai, China
9
Taipei City Hospital, Taipei, Taiwan
10
Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Gueishan, Taiwan
11
Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
12
Fukushima Medical University, Fukushima, Japan
13
Institute of Mental Health, Buangkok, Singapore
14
Department of Psychiatry, C.S.M. Medical University UP, Lucknow, Uttar Pradesh, India
15
Department of Psychiatry, National Seoul Hospital, Seoul, Korea
16
Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
17
Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur,
Malaysia
18
Association for the Improvement of Mental Health Programs, Geneva, Switzerland
19
Department of Pharmacology, National University of Singapore, Singapore, Singapore
20
School of Human Sciences, Seinan Gakuin University Fukuoka, Fukuoka, Japan
2

Objective Little is known about the pattern of QT interval (QTc) prolongation in Asian patients with schizophrenia. This study examined
trends of QTc prolongation in schizophrenia inpatients in six Asian countries and territories between 2004 and 2008/2009 and its independent
demographic and clinical correlates.
Method Data on 3482 hospitalized schizophrenia patients (2004 = 1826 and 2008/2009 = 1656) in six Asian countries and territories were
collected by either chart review or interviews during a 1-month period. Patients sociodemographic and clinical characteristics, prescriptions
of psychotropic drugs, and QTc interval were recorded using a standardized protocol and data collection procedure.
Results The frequency of QTc prolongation (>456 ms) was 2.4% in the whole sample, decreasing from 3.1% in 2004 to 1.6% in 2008/2009
(p = 0.004) with wide intercountry variations. However, this decreased trend was driven by decreased QTc prolongation detected in China
and Hong Kong (both p-values < 0.05). Multiple logistic regression analysis of the whole sample revealed that patients having more likely
to have an illness lasting longer than 5 years and received antipsychotics classied as list-1 drugs according to the Arizona Centre for
Education and Research on Therapeutics. Compared with 2004, patients in 2008/2009 were less likely to have QTc prolongation. Thioridazine caused QTc prolongation most frequently (odds ratio (OR) 4.4; 95% condence interval (CI) 1.215.2), followed by sulpiride (OR 2.4;
95% CI 1.34.5), clozapine (OR 2.4; 95% CI 1.44.2), and chlorpromazine (OR 1.9; 95% CI 1.073.5).
Conclusions Frequency of QTc prolongation was low in Asian patients with schizophrenia. QTc prolongation in schizophrenia decreased
in China and Hong Kong between 2004 and 2008/2009 but increased in Taiwan over the same period, remaining low in the other countries.
Copyright 2015 John Wiley & Sons, Ltd.
key wordsSchizophrenia; QTc prolongation; inpatients; Asia

INTRODUCTION
*Correspondence to: Y.-T. Xiang, 3/F, Building E12, Faculty of Health Sciences,
University of Macau, Avenida da Universidade, Taipa, Macau SAR, China.
Fax: +853-2288-2314; Phone: +853-8822-4223. E-mail: xyutly@gmail.com

Copyright 2015 John Wiley & Sons, Ltd.

QT interval (QTc) prolongation in the electrocardiogram (ECG) is a risk factor for ventricular arrhythmia,
Received 11 September 2014
Accepted 3 December 2014

qtc prolongation and schizophrenia

which is a frequent cause of cardiac arrest and sudden

death (Hennessy et al., 2002; Yang et al., 2011). The
reported frequency of QTc prolongation in schizophrenia varies greatly across studies from 0.5% to 38%
(Ramos-Rios et al., 2010). The main reasons for the
discrepancy are heterogeneity of cutoff points of QTc
prolongation (420 to 470 ms) (Warner et al., 1996;
Reilly et al., 2000), study design, and recruitment
criteria, as well as variations in patient and treatment
characteristics (Ramos-Rios et al., 2010). Common
correlates of QTc prolongation in schizophrenia included female gender, older age, smoking, heart diseases, and use of certain psychotropic medications,
such as thioridazine and sulpiride (Yang et al., 2011).
Examining the patterns of QTc prolongation and
their relationships with demographic and clinical characteristics could help clinicians reduce its negative
consequences. To date, most studies on QTc prolongation in schizophrenia patients have been conducted in
Western settings. There have been no international,
multicenter, and large-scale surveys in Asia. Considering that the pattern of QTc prolongation and its association varies across different countries (Ramos-Rios
et al., 2010), the ndings obtained in the West cannot
be applied to Asian patient populations. Therefore, investigations in this part of the world are required.
In 1999, a large-scale longitudinal, observational
pharmaco-epidemiological project, called Research in
East Asia on Psychotropic Prescription (REAP), was
initiated in six Asian countries and territories (China,
Hong Kong, Japan, Korea, Singapore, and Taiwan)
aiming to investigate and optimize the treatment for
schizophrenia inpatients in Asia (Shinfuku and Tan,
2008; Chong et al., 2010). The current study, an analysis of a subset of the REAP database, set out to (i) examine the characteristics and time trends of QTc
prolongation for hospitalized schizophrenia patients
during one census month each in 2004 and
2008/2009 in the aforementioned Asian regions and
(ii) explore the independent demographic and clinical
correlates of QTc prolongation in this population.

METHODS
Settings, study design, and subjects
The rst REAP survey was conducted in July 2001,
followed by the second (July 2004) and third surveys
(October 2008March 2009) with the same design examining the treatment of hospitalized schizophrenia
patients during the census month. Consensus meetings
to discuss data collection were held prior to each survey. For this analysis, participating patients had to
Copyright 2015 John Wiley & Sons, Ltd.

95

satisfy the following study entry criteria: (i) clinical diagnosis of schizophrenia according to either International Classication of Diseases-10 or Diagnostic and
Statistical Manual of Mental Disorders-IV; (ii) ECG
that was performed in the census month; and (iii) ability to comprehend the aims of the study and provide
informed consent if interviewed. Patients with clinically signicant medical conditions affecting the cardiovascular, respiratory, digestive, hematological,
endocrine, urinary, connective tissue, and nervous systems were excluded. Doses of antipsychotics were
converted into chlorpromazine equivalent milligrams
(APA, 1997; Kane et al., 1998; Woods, 2003). Mood
stabilizers included sodium valproate, lithium, carbamazepine, phenobarbital, phenytoin, lamotrigine,
topiramate, and zonisamide.
All eligible patients were examined consecutively at
each site. Demographic and clinical characteristics including age, sex, type of antipsychotics, anticholinergics, antidepressants, and mood stabilizers were
collected using a data collection form designed for
the study. ECG data were not recorded in the 2001 survey; thus, only the 2004 and 2008/2009 datasets were
analyzed in this study. Data were collected by either a
review of medical records only or a review supplemented by a clinical interview in both 2004 and
2008/2009 by the patients attending psychiatrists or
members of the research team with the agreement of
the treating psychiatrist. Antipsychotic polypharmacy
was dened as the concurrent use of two or more antipsychotic drugs (Xiang et al., 2012). Following earlier
studies (Reilly et al., 2000; Xie et al., 2002), the
threshold for QTc prolongation was set at 456 ms. This
gure was reached by a consensus of the REAP group
based on both the literature and local clinical experience in participating Asian countries/territories. According to the list of the Arizona Centre for
Education and Research on Therapeutics AZCERT,
2013; Vandael et al., 2014), antipsychotics are classied as list-1 drugs (droperidol, haloperidol, pimozide,
chlorpromazine, mesoridazine, sulpiride, and thioridazine) with well-established risk of QT prolongation
and Torsade de Pointes and list-2 drugs (clozapine,
olanzapine, paliperidone, quetiapine, risperidone,
sertindole, iloperidone, and ziprasidone) with possible
risk of QT prolongation and Torsade de Pointes. In this
study, the antipsychotics were divided into three
groups (list 1, list 2, and others) according to the
AZCERT classication for statistical analyses.
The study was approved by the clinical research
ethics committees of the respective institutions. Given
the anonymous nature of the retrospective chart review
and the minimal risk to patients, in line with local
Hum. Psychopharmacol Clin Exp 2015; 30: 9499
DOI: 10.1002/hup

96

y.-t. xiang

ethical standards, informed consent was not required at

some study sites, provided that only the case notes
were reviewed (Shinfuku and Tan, 2008). All patients
who were interviewed gave written or verbal consent
according to the requirements of the respective clinical
research ethics committees.
Statistical analysis
The data were analyzed using SPSS 19.0 (SPSS Inc.,
Chicago, IL, USA) for Windows. Comparisons between the two surveys with respect to QTc prolongation were conducted using chi-squared tests. Multiple
logistic regression analysis with Enter method was
used to determine the demographic and clinical variables that were independently associated with QTc
prolongation, controlling the multivariate analyses for
country/region. In addition, the independent associations between QTc prolongation and commonly prescribed antipsychotics (prescription patterns >1% in
the study sample) were examined using multiple logistic regression analysis with Enter method after controlling for age, gender, duration of illness, and
concurrent use of antidepressants. The variance of
QTc prolongation explained by signicant correlates
was provided. The level of signicance for all analyses
was set at 0.05 (two-tailed).
RESULTS
Twenty-ve psychiatric facilities participated in 2004
and 50 in 2008/2009, involving altogether 3482 patients: 1826 in 2004 and 1656 in 2008/2009. In the
whole sample, the frequency of QTc prolongation
was 2.4% (2.5% in men and 2.1% in women,
2 = 0.6, df = 1, p = 0.43), decreasing from 3.1% in
2004 to 1.6% in 2008/2009 ( 2 = 8.4, df = 1,
p = 0.004). Table 1 shows the sociodemographic and
clinical characteristics and use of psychotropic medications in the whole sample and separately by study site
and year of the survey. Of the six countries/territories
that participated in both surveys, the frequency of the
QTc prolongation signicantly declined in China and
Hong Kong (both p-values < 0.05), without change in
Japan, Korea, and Singapore (all p-values > 0.05),
but increased in Taiwan (p = 0.001).
Table 2 shows the independent demographic and
clinical factors that were signicantly associated with
QTc prolongation. Patients having QTc prolongation
were more likely to have an illness lasting longer than
5 years and received antipsychotics classied as list-1
drugs according to the AZCERT. Also, compared with
the 2004 survey, patients in 2008/2009 were less likely
to have QTc prolongation. The signicant correlates
Copyright 2015 John Wiley & Sons, Ltd.

ET AL.

accounted for 9% of the variance of QTc prolongation

(p < 0.001).
Table 3 presents the independent associations between QTc prolongation and commonly prescribed antipsychotic medications. Thioridazine was more likely
to cause QTc prolongation (OR 4.4; 95% CI 1.215.2),
followed by sulpiride (OR 2.4; 95% CI 1.34.5), clozapine (OR 2.4; 95% CI 1.44.2), and chlorpromazine
(OR 1.9; 95% CI 1.073.5).
DISCUSSION
To the best of our knowledge, this is the rst international study that examined QTc prolongation in
schizophrenia inpatients in Asia. The main nding of
the study is that a decreasing percentage of Asian
schizophrenia inpatients had QTc prolongation, falling
from 3.1% in 2004 to 1.6% in 2008/2009. However,
this decline in the whole sample was driven by the decreasing per cent of QTc prolongation in China (from
9.5% in 2004 to 0.3% in 2008/2009) and Hong Kong
(from 2.4% in 2004 to 0% in 2008/2009). Our nding
that 2.4% of patients had QTc prolongation is at the
very low end of the range reported from other surveys,
in which QTc prolongation in patients with schizophrenia ranged from 0.5% to 38% (Ramos-Rios
et al., 2010; Yang et al., 2011). The reason for differences between our nding and those from other studies
is likely due to a number reasons, including inconsistent cutoff values for QTc prolongation ranging from
420 to 470 ms (Warner et al., 1996; Reilly et al.,
2000), differences in patient characteristics (young
versus older adults and Caucasian versus Asian patients), study settings (inpatients versus outpatients),
and treatment characteristics (rst-generation antipsychotic (FGA) versus second-generation antipsychotic
(SGA) use, high versus medium/low dose, and
comedications use). Therefore, comparisons across
different studies should be made with caution. In a
study conducted in China, Yang et al. (2011) reported
that the percentage of QTc prolongation in Chinese
hospitalized schizophrenia patients was 4.5%, which
was somewhat higher than our gure in the whole
sample (2.4%) but in the range of Chinese patients between our two surveys (9.5% in 2004 and 0.3% in
2009). Interestingly, the percentage of QTc prolongation has decreased in China during the study period,
which may be explained by the widespread use of
SGAs and decreased use of FGAs; as compared with
FGAs, SGAs have a lower risk of QTc prolongation
(Jolly et al., 2009; Ray et al., 2009). In addition, the increasing awareness of drug-induced long QT syndrome could be another possible reason. On the other
Hum. Psychopharmacol Clin Exp 2015; 30: 9499
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qtc prolongation and schizophrenia

Table 1.

Sociodemographic and clinical characteristics and psychotropic drug prescription in Asia in 2004 and 2008/2009
China

Patients (n)
Male gender (%)
Age (years) (mean SD)
>/= 65 years (%)
Illness duration
>5 years (%)
Antipsychotics (%)
FGA (%)
SGA (%)
AZCERT classication
List 1 (%)
List 2 (%)
Antipsychotic
polypharmacy (%)
CPZeq (mean SD)
<300 mg/day (%)
300599 mg/day (%)
600999 mg/day (%)
>/=1000 mg/day (%)
Anticholinergics (%)
Antidepressants (%)
Mood stabilizers (%)
QTc prolongation (%)

Hong Kong

Japan

Korea

Singapore

Taiwan

Total

2004

2008/
2009

2004

2008/
2009

2004

2008/
2009

2004

2008/
2009

2004

2008/
2009

2004

2008/
2009

2004

2008/
2009

493
50.9
38.8
14.7
4.3

374
69.5
42.7
13.1
1.1

42
59.5
40.7
11.1
2.4

42
52.4
39.5
11.8
0

502
56.6
51.8
15.2
22.9

482
55.8
51.5
15.4
23.2

412
59.7
40.9
10.8
1.0

273
54.6
43.6
11.9
4.0

3
0
42.3
5.1
0

100
50.0
42.8
10.4
0

374
63.1
39.1
11.1
2.1

385
69.9
43.2
11.0
2.3

1826
57.1
43.0
14.3
8.2

1656
61.5
45.5
13.6
8.2

62.3

73.0

85.7

78.6

90.6

87.3

85.2

82.4

78.0

83.7

90.6

80.2

83.3

34.9
75.9

24.9
86.1

23.8
71.4

23.8
57.1

65.5
76.1

52.3
85.5

66.3
45.9

46.9
74.0

66.7
0

49.0
50.0

39.0
64.4

35.8
76.4

51.0
66.6

40.5
78.7

30.2
77.1
23.9

20.3
83.2
36.4

19.0
61.9
26.2

21.4
69.0
26.2

46.2
69.1
66.7

35.5
72.8
60.4

52.7
48.3
37.6

44.7
63.4
43.2

33.3
0
66.7

33.0
47.0
74.0

29.1
59.6
13.9

27.5
65.7
28.6

39.2
64.3
36.9

31.2
70.3
44.7

465
309
69.8
22.3
7.5
0.4
45.4
5.9
23.5
9.5

543
380
64.2
24.1
9.4
2.4
38.8
8.8
30.5
0.3

480
287
61.9
35.7
2.4
0
50.0
11.9
40.5
2.4

538
400
71.4
14.3
9.5
4.8
45.2
11.9
35.7
0

633
605
61.6
21.3
10.4
6.8
69.3
2.2
34.5
1.0

623
495
56.0
26.6
11.0
6.4
64.7
2.9
36.1
1.5

651
556
60.9
19.9
9.0
10.2
33.5
1.9
21.8
0.2

710
562
54.6
21.6
17.6
6.2
68.5
11.4
39.2
0.4

602
440
33.3
66.7
0
0
100
33.3
0
0

397
323
81.0
12.0
6.0
1.0
67.0
22.0
28.0
0

483
334
66.0
24.3
7.2
2.4
55.6
12.8
33.7
0.5

492
367
69.1
20.5
7.5
2.9
55.8
14.0
36.4
4.4

558
477
64.5
22.3
8.4
4.8
51.6
5.6
28.6
3.1

573
452
62.6
22.6
10.6
4.3
57.1
9.6
34.9
1.6

CPZeq, chlorpromazine equivalents; FGA, rst-generation antipsychotic; SGA, second-generation antipsychotic; SD, standard deviation; AZCERT, Arizona
Centre for Education and Research on Therapeutics.

hand, there is no simple explanation for the increasing

percentage of QTc prolongation (0.5% in 2004 and
4.4% in 2009) in Taiwan, which was based on similarly sized samples in each of the two surveys as in
China (close to 400 subjects). This trend needs to be
re-examined in future REAP surveys, and the
frequency/trends of sudden cardiac death in patients
with schizophrenia should be investigated at the same
time.
A few sociodemographic and clinical characteristics
were independently associated with QTc prolongation
in this study. Patients having a longer illness were
more likely to have QTc prolongation, which could
be explained by the fact that chronic schizophrenia patients usually have poor physical health including cardiovascular abnormalities (Marder et al., 2004). As
expected, QTc prolongation was independently associated with more frequent use of antipsychotics on
AZCERT list 1. Multiple logistic regression analysis
revealed that compared with the 2004 gure, the risk
of QTc prolongation decreased signicantly by 2009
(OR: 0.6) even after controlling for use of other psychotropic medications. The decrease of risk may be
due to the changes of unmeasured variables related to
QTc prolongation.
Copyright 2015 John Wiley & Sons, Ltd.

The relationships between individual antipsychotics

and QTc prolongation remain controversial (RamosRios et al., 2010; Vandael et al., 2014). In this study,
thioridazine, clozapine, sulpiride, and chlorpromazine
increased the risk of QTc prolongation, partly replicating earlier ndings (Yang et al., 2011; Vandael et al.,
2014). Because of its especially strong QTc prolonging
effect by blocking the delayed rectier potassium
channel in the myocardium leading to abnormal repolarization (Reilly et al., 2000), thioridazine has been
removed from the market in many Western countries.
Unexpectedly, haloperidol was associated with low
risk for QTc prolongation in this study. There is no
ready explanation for the reasons behind this nding
because of the cross-sectional nature of the REAP surveys. This nding needs to be re-examined with a prospective design.
Some earlier studies have found a gender difference
in QTc prolongation, which could be attributed to different serum testosterone levels (Vieweg et al., 2009;
Van Noord et al., 2010), antipsychotic doses (Reilly
et al., 2000), antipsychotic dose or polypharmacy
(Anil Yagcioglu et al., 2005), and concurrent use of
antidepressants (Reilly et al., 2000). Other studies
(Anil Yagcioglu et al., 2005; Sumic et al., 2007;
Hum. Psychopharmacol Clin Exp 2015; 30: 9499
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y.-t. xiang

Table 2. Factors independently associated with QTc prolongation in the

combined sample (n = 3482). Multiple logistic regression analysis with
patients without QTc prolongation as the reference group*

Male gender
Age (years)
>/=65
CPZeq (mg/day)
<300 mg/day
300599 mg/day
600999 mg/day
>/=1000 mg/day
Length of illness (>5 years)
Antipsychotics
Others
AZCERT list 2
AZCERT list 1
Anticholinergics
Antidepressants
Mood stabilizers
Antipsychotic polypharmacy
Study time
2004 survey
2009 survey

p-value

Odds ratio

95% condence
interval

0.33

1.2

0.72.0

0.60

1.2

0.52.6

0.37
0.45
0.14
0.02

1.0
0.7
0.7
0.2
2.3

0.41.3
0.31.6
0.021.6
1.14.8

0.88
0.03
0.63
0.35
0.053
0.17

1.0
1.1
2.5
0.8
1.4
1.5
0.6

0.42.6
1.16.4
0.51.4
0.63.2
0.92.5
0.41.2

0.02

1.0
0.5

0.30.9

R = 0.09, p < 0.001.

*Centers in India, Malaysia, and Thailand joined the survey in 2009; therefore, they were not included in multiple logistic regression analysis; study
site was used as a covariate in the analysis, AZCERT list 1: droperidol,
haloperidol, pimozide, chlorpromazine, mesoridazine, sulpiride, and thioridazine and AZCERT list 2: clozapine, olanzapine, paliperidone,
quetiapine, risperidone, sertindole, iloperidone, and ziprasidone.
CPZeq, chlorpromazine equivalents; FGA, rst-generation antipsychotic;
SGA, second-generation antipsychotic; AZCERT, Arizona Centre for Education and Research on Therapeutics.

Table 3. Independent associations between QTc prolongation and

individual antipsychotic medications (n = 3482). Multiple logistic
regression analysis with patients without QTc prolongation as the
reference group*

Chlorpromazine (n = 443)
Haloperidol (n = 626)
Sulpiride (n = 255)
Thioridazine (n = 42)
Clozapine (n = 544)
Olanzapine (n = 464)
Quetiapine (n = 335)
Risperidone (n = 1120)

p-value

Odds ratio

95% condence
interval

0.02
0.03
0.003
0.01
0.001
0.03
0.053
0.056

1.9
0.4
2.4
4.4
2.4
0.3
0.2
0.5

1.073.5
0.10.9
1.34.5
1.215.2
1.44.2
0.10.9
0.051.02
0.31.01

*Only antipsychotics prescribed to more than 1% of the sample were included in the analysis. Age, gender, length of illness, and concurrent use
of antidepressants were used as covariates.

Correll et al., 2009; Yang et al., 2011), including the

current one, did not replicate these ndings.
Several limitations to this study need to be acknowledged. First, a number of clinical variables possibly
linked to QTc prolongation, such as serum potassium
and magnesium levels, history of cardiovascular illness and smoking, were not recorded. Second, only a
Copyright 2015 John Wiley & Sons, Ltd.

ET AL.

limited number of participating facilities in each

country/region were involved; therefore, the ndings
cannot be generalized to all schizophrenia patients in
this part of the world. Third, because of logistic reasons, QTc prolongation was only recorded as present
or absent in the REAP surveys without recording the
QTc interval. In addition, ECG was performed with
different machines across the participating institutions.
Fourth, patients with clinically signicant medical conditions were excluded, which likely to lead to
underestimating the percentage of QTc prolongation.
Finally, this was a cross-sectional study; thus, the causality between QTc prolongation and use of psychotropic medications could not be explored. However, the
limitations of this study are partly offset by its
strengths that include the large sample size and its regional diversity.
In conclusion, the two REAP surveys showed that
QTc prolongation in Asian schizophrenia inpatients is
generally low compared with international standards.
QTc prolongation has gradually decreased in China
and Hong Kong but increased in Taiwan over the past
years, while remaining low in the other parts of Asia.
There is considerable variation in QTc prolongation
across Asian countries and territories, which requires
further studies.
CONFLICT OF INTEREST
Dr Correll has been a consultant and/or advisor to or
has received honoraria from Bristol-Myers Squibb,
Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Janssen/J&J, Lundbeck, MedAvante,
Medscape, Otsuka, Pzer, ProPhase, Roche, Sunovion,
Supernus, and Takeda. He has received grant support
from Bristol-Myers Squibb, Novo Nordisk A/S, and
Otsuka. Other authors do not report any conict of
interests specically related to the topic of this paper.
ACKNOWLEDGEMENTS
This study was supported in part by grants from the National Natural Science Foundation of China (81171270,
30800367, and 30770776), the Beijing Nova Program of
the Beijing Municipal Science and Technology Commission (2008B59), the Chinese University of Hong Kong
(Direct Grant for Research; Project 2041454), the Institute
of Mental Health Research Grant (CRC 249/2008) in
Singapore, and the Taiwan Bureau of National Health
Insurance (DOH92-NH-1025), Chang Gung Memorial
Hospital (CMRPG83043), and the Taipei City Government (97001-62-010) in Taiwan. The authors are grateful
to the following clinicians involved in the data collection:
Hong Deng and Wei Hao in China; Ajit Avasthi, Dipesh
Hum. Psychopharmacol Clin Exp 2015; 30: 9499
DOI: 10.1002/hup

qtc prolongation and schizophrenia

Bhagabati, Roy Abraham Kallivayalil, Shubhangi R.
Parkar, and YC Janardhan Reddy in India; Tateno Masaru,
Masamune Yayoi, Akiyama Tsuyoshi, Sato Soichirou,
Nakagome Kazuyuki, Nakamura Jun, and Kuroki
Toshihide in Japan; Tae-Yeon Hwang, Seok Hyeon Kim,
Yo Wang Lee, and Jong-Il Lee in Korea; Tung-ping
Su, Shih-ku Lin, Tzu-ting Chen, Chieh-hsin Chang,
Hong-chieh Hsu, Chi-Fa Hung, and Cheng-chung Chen
in Taiwan; Krisakorn Sukavatvibul, Jittima Kleawtanong,
Tantawan Suradechasakul, Manote Lotrakul, and Usaree
Srisutudsanavong in Thailand; and Norharlina Bahar in
Malaysia.

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Hum. Psychopharmacol Clin Exp 2015; 30: 9499

DOI: 10.1002/hup

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