Clinical Guidance: Long QT Interval
Medications associated with a long QT interval include haloperidol, phenothiazines, fluoxetine, citalopram/escitalopram, methadone, sertindole, and clotiapine (the last two are not used in the U.S.). The likelihood of a long QT interval increases if a patient taking one of these drugs has hypokalemia, hepatitis C, HIV, or abnormal T wave morphology. Girardin et al. (p. 1468) discovered these relationships from routine electrocardiograms of 6,790 patients admitted to a Swiss public psychiatric hospital over 5 years. Of 62 patients with drug-induced long QT, five died suddenly and seven developed torsades de pointes within 72 hours after long QT detection.