Pattern of Electrocardiographic Abnormalities among Patients on long-term psychotropic Medication in a Nigerian Tertiary Hospital

Abstract

Background: Psychotropic medications are administered for various psychiatric conditions with associated significant high morbidity and mortality. Electrocardiographic (ECG) abnormalities had been reported among patients on psychotropic medications; however, baseline or follow-up ECGs are rarely done during routine clinical practice especially in developing country. Objective: To study the pattern of ECG abnormalities among patient using psychotropic drugs in a Nigerian tertiary hospital. Materials and Methods: This was a cross-sectional comparative study conducted in a population of 134 psychiatric patients on psychotropics and 75 controls. All subjects had detailed clinical history and resting electrocardiogram done. ECG abnormalities were divided into minor and major abnormalities based on Novacode criteria. A 95% confidence interval was used while statistical significance was set at P < 0.05. Results: The prevalence of at least one ECG abnormality in the patient was 35.8% and comparable with the control group of 28.0% (p=0.249). Overall, 32.8% and 3.0% of the patients as well as 25.3% and 2.7% of the controls had minor and major ECG abnormalities respectively based on Novacode Criteria and these differences were not statistically different. The male patients had a considerably higher prevalence of ECG abnormality than their female counterparts (P<0.001). Conclusion: Psychotropic drugs result in abnormal ECG changes in therapeutic doses howbeit mostly benign. This study provides some evidence that there is a need for regular ECG monitoring especially in patients with other cardiovascular risk factors.

Keywords: Psychotropic drugs, ECG abnormalities, Nigerian Hospita