Abstract
Many psychiatric medications have the potential to cause QT interval prolongation and increase the risk for torsades de pointes (TdP). While it is challenging to risk-stratify most agents, citalopram is thought to convey greater risk than most antidepressants, and thioridazine, chlorpromazine and ziprasidone are more strongly associated with QT interval prolongation and TdP than are other antipsychotics. Methadone also has the potential to cause significant QT interval prolongation and TdP, and should be used with caution, particularly in patients who may be at higher risk. Psychiatrists should be aware of the potential for medications to prolong the QT interval and TdP, and should think carefully about the need for monitoring and consultation with colleagues in cardiology in certain situations.
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