QT interval prolongation in acute antipsychotic poisoning: systematic review and recommendations
The QT Interval Prolongation in Clinical Toxicology Workgroup recommends the use of screening electrocardiograms in all patients with acute antipsychotic medication overdose and cardiac monitoring in patients with at-risk overdoses from thioridazine, amisulpride, and ziprasidone. The QT Interval Prolongation in Clinical Toxicology Workgroup suggests the same approach for patients with overdoses of haloperidol, iloperidone, pipamperone and pimozide. The risk of torsade de pointes is likely overstated for acute antipsychotic medication overdose as a general class group, and concern should rather focus on a few specific medications.
Authors
- Bryan D. Hayes (ORCID: https://orcid.org/0000-0001-7349-6770)
- Lotte Christine Groth Høgberg (ORCID: https://orcid.org/0000-0003-0252-2470)
- Angela Smith (ORCID: https://orcid.org/0000-0002-5926-4946)
- Geoffrey K. Isbister (ORCID: https://orcid.org/0000-0003-1519-7419)
- Anselm Wong (ORCID: https://orcid.org/0000-0002-6817-7289)
- Chris Yates (ORCID: https://orcid.org/0000-0003-0473-5445)
- Ingrid Berling (ORCID: https://orcid.org/0000-0002-8993-2693)
- Constance A. Mackenzie (ORCID: https://orcid.org/0000-0002-6309-074X)
- Sophie Gosselin (ORCID: https://orcid.org/0000-0002-0694-5588)
- Darren M. Roberts (ORCID: https://orcid.org/0000-0001-9101-7577)
- Robert S. Hoffman (ORCID: https://orcid.org/0000-0002-0091-9573)
- Raido Paasma
- Rittirak Othong (ORCID: https://orcid.org/0000-0002-5926-353X)
- Ana Maria Alicia Ferrer Dufol (ORCID: https://orcid.org/0000-0001-6289-145X)
- Matthew Stanton (ORCID: https://orcid.org/0000-0002-1515-9925)
- Davide Lonati (ORCID: https://orcid.org/0000-0001-6285-3445)
- Fridtjof Heyerdahl (ORCID: https://orcid.org/0000-0001-9602-4370)
- Benjamin W. Hatten
Institutions
- Oslo University Hospital (NO)
- Danish Emergency Management Agency (DK)
- Texas Department of State Health Services (US)
- The University of Melbourne (AU)
- University of Oslo (NO)
- University of Colorado Boulder (US)
- Medical College of Wisconsin (US)
- Navamindradhiraj University (TH)
- Royal Prince Alfred Hospital (AU)
- Danish Medicines Agency (DK)
- Hospital for Sick Children (CA)
- Bispebjerg Hospital (DK)
- Tartu University Hospital (EE)
- Massachusetts General Hospital (US)
- Istituti Clinici Scientifici Maugeri (IT)
- East Tallinn Central Hospital (EE)
- Hôpital Charles-Le Moyne (CA)
- Austin Health & Human Services Department (US)
- Institute of Clinical Research (US)
- Monash Health (AU)
- Health Research Institute of the Balearic Islands (ES)
- Calvary Mater Newcastle Hospital (AU)
- Hunter New England Local Health District (AU)
- Austin Health (AU)
- Institute of Pharmacology (CZ)
- Monash University (AU)
- New York University (US)
- University of Newcastle Australia (AU)
Publication Details
- Journal
- Clinical Toxicology
- Published
- 2025-11-02
- DOI
- https://doi.org/10.1080/15563650.2025.2554950
- Primary Topic
- Cardiac electrophysiology and arrhythmias
- Type
- article
- Field-Weighted Citation Impact
- 0.00