Objective The aim of this study was to compare the effect of quetiapine extended release (ER) versus aripiprazole on corrected QT interval (QTc) and QT dispersion (QTd) in youths with first-episode psychosis. Methods Youths12–17yearswererandomizedtoquetiapineER(dailydoserange = 50to800mg)oraripiprazole(dailydoserange = 2.5 to 30 mg) in a 12-week double-blinded trial and examined at weeks 0, 4, and 12. Primary outcome was QTc change using Hodges formula (QTcH); secondary outcomes included QTcH > 450 ms, QTcH > 500 ms, QTcH change > 60 ms, QTd, and heart rate (HR). Results Among113randomizedyouths,follow-upECGwasavailablefor93patients(82.3%)(age = 15.8 ± 1.3years,males = 34.4%, schizophrenia = 67.7%). Quetiapine ER treatment (n = 47) was associated with a significant increase in QTcH of + 6.8 ± 20.2 ms (p = 0.025),whilethechangefrombaselineinpatientsreceivingaripiprazole(n = 46)wasnon-significant(− 3.4 ± 18.9ms,p =0.225).One patient inthequetiapineERgrouphadaQTcHchangeof + 62.3ms.Age,sex,smoking,bodymassindex,andconcomitantmedication were not significantly associated with QTcH change, but higher baseline potassium was correlated to higher QTcH change in the quetiapine ER group. The HR increased significantly with quetiapine ER (+ 11.0 ± 14.2 bpm, p < 0.001) but not with aripiprazole (− 0.8 ± 12.0 bpm, p = 0.643). QTd did not significantly change with quetiapine ER or aripiprazole. Conclusion QTcHandHRincreasedsignificantlywithquetiapineER,althoughchangesweresmallandlikelynotclinicallysignificant in otherwise healthy patients. QTcH and HR were unchanged with
Psychopharmacology – Springer Journals
Published: Nov 29, 2017
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