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Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation

The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate ≥ 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in...

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Autores principales: Lim, Andy K. H., Azraai, Meor, Pham, Jeanette H., Looi, Wenye F., Wirth, Daniel, Ng, Ashley S. L., Babu, Umesh, Saluja, Bharat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038822/
https://www.ncbi.nlm.nih.gov/pubmed/33917515
http://dx.doi.org/10.3390/jcm10071534
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author Lim, Andy K. H.
Azraai, Meor
Pham, Jeanette H.
Looi, Wenye F.
Wirth, Daniel
Ng, Ashley S. L.
Babu, Umesh
Saluja, Bharat
author_facet Lim, Andy K. H.
Azraai, Meor
Pham, Jeanette H.
Looi, Wenye F.
Wirth, Daniel
Ng, Ashley S. L.
Babu, Umesh
Saluja, Bharat
author_sort Lim, Andy K. H.
collection PubMed
description The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate ≥ 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 °C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2).
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spelling pubmed-80388222021-04-12 Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation Lim, Andy K. H. Azraai, Meor Pham, Jeanette H. Looi, Wenye F. Wirth, Daniel Ng, Ashley S. L. Babu, Umesh Saluja, Bharat J Clin Med Article The use of antipsychotic medications is associated with side effects, but the occurrence of severe tachycardia (heart rate ≥ 130 per minute) is not well described. The aim of this study was to determine the frequency and strength of the association between antipsychotic use and severe tachycardia in an inpatient population of patients with mental illness, while considering factors which may contribute to tachycardia. We retrospectively analyzed data from 636 Medical Emergency Team (MET) calls occurring in 449 psychiatry inpatients in three metropolitan hospitals co-located with acute medical services, and used mixed-effects logistic regression to model the association between severe tachycardia and antipsychotic use. The median age of patients was 42 years and 39% had a diagnosis of schizophrenia or psychotic disorder. Among patients who experienced MET calls, the use of second-generation (atypical) antipsychotics was commonly encountered (70%), but the use of first-generation (conventional) antipsychotics was less prevalent (10%). Severe tachycardia was noted in 22% of all MET calls, and sinus tachycardia was the commonest cardiac rhythm. After adjusting for age, anticholinergic medication use, temperature >38 °C and hypoglycemia, and excluding patients with infection and venous thromboembolism, the odds ratio for severe tachycardia with antipsychotic medication use was 4.09 (95% CI: 1.64 to 10.2). MDPI 2021-04-06 /pmc/articles/PMC8038822/ /pubmed/33917515 http://dx.doi.org/10.3390/jcm10071534 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, Andy K. H.
Azraai, Meor
Pham, Jeanette H.
Looi, Wenye F.
Wirth, Daniel
Ng, Ashley S. L.
Babu, Umesh
Saluja, Bharat
Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title_full Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title_fullStr Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title_full_unstemmed Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title_short Severe Tachycardia Associated with Psychotropic Medications in Psychiatric Inpatients: A Study of Hospital Medical Emergency Team Activation
title_sort severe tachycardia associated with psychotropic medications in psychiatric inpatients: a study of hospital medical emergency team activation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038822/
https://www.ncbi.nlm.nih.gov/pubmed/33917515
http://dx.doi.org/10.3390/jcm10071534
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