Table 4.
Psychotropic drugs, which in some studies, were weakly associated with QT interval prolongation and/or torsades de pointes.
| International denomination | Commercial denomination | Therapeutic class |
|---|---|---|
| Amitriptyline | Elavil® | Tricyclic anti-depressant/depression |
| Citalopram | Celexa® | Anti-depressant/depression |
| Clomipramine | Anafranil® | Tricyclic anti-depressant/depression |
| Desipramine | Pertofrane® | Tricyclic anti-depressant |
| Doxepin | Sinequan® | Tricyclic anti-depressant/depression |
| Fluoxetine | Sarafem® | Anti-depressant/depression |
| Fluoxetine | Prozac® | Anti-depressant/depression |
| Imipramine | Norfranil® | Tricyclic anti-depressant/depression |
| Nortriptyline | Pamelor® | Tricyclic anti-depressant/depression |
| Paroxetine | Paxil® | Anti-depressant/depression |
| Protriptyline | Vivactil® | Tricyclic anti-depressant/depression |
| Sertraline | Zoloft® | Anti-depressant/depression |
| Trazodone | Desyrel® | Anti-depressant/depression, insomnia |
| Trimipramine | Surmontil® | Tricyclic anti-depressant/depression |
However, the risk of torsades de pointes is low when used at recommended doses and/or in patients without risk factors (e.g., bradycardia, electrolyte disturbances and congenital long QT syndrome, in association with inhibitors of CYP 450 responsible for the metabolism of psychotropic drugs concerned).
NB. Classification of Arizona does not include all psychotropic drugs that may prolong the QT interval and cause torsades de pointes. This is the case, for example, of pimozide. It is necessary therefore to be especially careful and evaluate the risk for non-listed drugs. NB. Actions to be taken when prescribing neuroleptics and anti-depressants to patients with disorders of repolarization and/or treated by antiarrhythmic drugs or other potentially torsadogenic drugs: Use a neuroleptic or an anti-depressant at low torsadogenic potential. Make sure the ion balance, particularly in serum potassium. Discard, if possible, the use of drugs that induce bradycardia. Perform an ECG and an ionic balance before the introduction of torsadogenic psychotropics (Lin et al., 2004; Narang et al., 2010). A cardiology consultation may sometimes be necessary.