TY - JOUR
T1 - Low dose oral haloperidol does not prolong QTc interval in older acutely hospitalised adults
T2 - Results fromA subanalysis of a randomised double-blind placebo-controlled study
AU - HARPOON Investigators
AU - Schrijver, Edmée J.M.
AU - Verstraaten, Maaike
AU - Van De Ven, Peter M.
AU - Bet, Pierre M.
AU - Van Strien, Astrid M.
AU - De Cock, Carel
AU - Nanayakkara, Prabath W.B.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: Haloperidol is the most frequently prescribed antipsychotic for delirium symptoms. The risk of QTc prolongation often raises concerns, although the effect of haloperidol on QTc interval has not yet been investigated in a randomised placebo-controlled fixed-dose study. Methods: A subanalysis of a randomised double-blind placebo-controlled study was conducted to evaluate the effect of Patients aged 70 years and over enrolled in a randomised double-blind placebo-controlled trial received prophylactic haloperidol 1 mg or placebo 1 mg orally twice-daily (maximum of 14 doses) on QTc interval in patients aged 70 years and over. Bedside 12-lead electrocardiograms (ECGs) were recorded before, during and after the one-week intervention period. Automatic QTc measurements were obtained in addition to manual measurements of QT and RR intervals, blinded for treatment status. Manual measurements were corrected (QTc) using Bazett (QTc-B), Framingham (QTc-Fa), Fridericia (QTc-Fi) and Hodges (QTc-H) methods. Mixed model analyses were used to test for differences in longitudinal course of QTc between patients receiving haloperidol and placebo. Results: ECG recordings of 72 patients (haloperidol n = 38) were analysed, 45.8% male. Median (range) haloperidol serum concentration on day 4 was 0.71 (0.32 - 1.82) µg/L (n = 23). Longitudinal course of mean QTc did not significantly differ between treatment arms for any of the automatic or manually derived QTc values. Conclusions: Low dose oral haloperidol did not result in QTc prolongation in older acutely hospitalised patients. Results may not be generalizable to patients with existing ECG abnormalities such as atrial fibrillation.
AB - Objective: Haloperidol is the most frequently prescribed antipsychotic for delirium symptoms. The risk of QTc prolongation often raises concerns, although the effect of haloperidol on QTc interval has not yet been investigated in a randomised placebo-controlled fixed-dose study. Methods: A subanalysis of a randomised double-blind placebo-controlled study was conducted to evaluate the effect of Patients aged 70 years and over enrolled in a randomised double-blind placebo-controlled trial received prophylactic haloperidol 1 mg or placebo 1 mg orally twice-daily (maximum of 14 doses) on QTc interval in patients aged 70 years and over. Bedside 12-lead electrocardiograms (ECGs) were recorded before, during and after the one-week intervention period. Automatic QTc measurements were obtained in addition to manual measurements of QT and RR intervals, blinded for treatment status. Manual measurements were corrected (QTc) using Bazett (QTc-B), Framingham (QTc-Fa), Fridericia (QTc-Fi) and Hodges (QTc-H) methods. Mixed model analyses were used to test for differences in longitudinal course of QTc between patients receiving haloperidol and placebo. Results: ECG recordings of 72 patients (haloperidol n = 38) were analysed, 45.8% male. Median (range) haloperidol serum concentration on day 4 was 0.71 (0.32 - 1.82) µg/L (n = 23). Longitudinal course of mean QTc did not significantly differ between treatment arms for any of the automatic or manually derived QTc values. Conclusions: Low dose oral haloperidol did not result in QTc prolongation in older acutely hospitalised patients. Results may not be generalizable to patients with existing ECG abnormalities such as atrial fibrillation.
KW - Aged
KW - Aged 80
KW - Haloperidol
KW - Over
KW - Prolongation
KW - QTc interval
UR - http://www.scopus.com/inward/record.url?scp=85052572139&partnerID=8YFLogxK
M3 - Article
SN - 1671-5411
VL - 15
SP - 401
EP - 407
JO - Journal of geriatric cardiology
JF - Journal of geriatric cardiology
IS - 6
ER -