{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:49:49Z","timestamp":1793310589161,"version":"4.5.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>QT<jats:sub>c<\/jats:sub> prolongation carries the risk of ventricular tachyarrhythmia (Torsades de Pointes) and sudden cardiac death. Psychotropic drugs can affect ventricular repolarization and thus prolong the QT<jats:sub>c<\/jats:sub> interval. The present study sought to investigate the risk factors (pharmacological and non-pharmacological) of severe QT<jats:sub>c<\/jats:sub> prolongation in gerontopsychiatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electrocardiograms of patients on a gerontopsychiatric ward were screened for QT<jats:sub>c<\/jats:sub> prolongation. Medication lists were examined utilizing the AzCERT classification. Potential drug interactions were identified with the electronic drug interaction program mediQ.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall prevalence of QT<jats:sub>c<\/jats:sub> prolongation was 13.6%, with 1.9% displaying severe QT<jats:sub>c<\/jats:sub> prolongation (\u2265\u2009500 ms). No statistically significant differences between patients with moderate and severe QT<jats:sub>c<\/jats:sub> prolongation were identified; however, patients with severe QT<jats:sub>c<\/jats:sub> prolongation tended to take more drugs (<jats:italic>p<\/jats:italic>\u2009=\u20090.063). 92.7% of patients with QT<jats:sub>c<\/jats:sub> prolongation took at least one AzCERT-listed drug, most frequently risperidone and pantoprazole. Risperidone and pantoprazole, along with pipamperone, were also most frequently involved in potential drug interactions. All patients displayed additional risk factors for QT<jats:sub>c<\/jats:sub> prolongation, particularly cardiac diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In addition to the use of potentially QT<jats:sub>c<\/jats:sub>-prolonging drugs, other risk factors, especially cardiac diseases, appear to be relevant for the development of QT<jats:sub>c<\/jats:sub> prolongation in gerontopsychiatric patients. Pantoprazole was frequently involved in potential drug interactions and should generally not be used for more than 8 weeks in geriatric populations. As clinical consequences of QT<jats:sub>c<\/jats:sub> prolongation were rare, potentially QT<jats:sub>c<\/jats:sub>-prolonging drugs should not be used overcautiously; their therapeutic benefit should be considered as well. It is paramount to perform diligent benefit\u2013risk analyses prior to the initiation of potentially QT<jats:sub>c<\/jats:sub>-prolonging drugs and to closely monitor their clinical (side) effects.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1157996","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T05:10:59Z","timestamp":1679548259000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Determinants of severe QTc prolongation in a real-world gerontopsychiatric setting"],"prefix":"10.3389","volume":"14","author":[{"given":"Martin","family":"Schulze Westhoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schr\u00f6der","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Heck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabea","family":"Pfister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Jahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Krause","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Wedeg\u00e4rtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Bleich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai G.","family":"Kahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tillmann H. 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