Possible association of QTc interval prolongation with co-administration of quetiapine and lovastatin

• Published in: Biological psychiatry (1969) 2002-02, Vol.51 (3), p.264-265
• Main Authors: Furst, Benjamin A., Champion, Katherine M., Pierre, Joseph M., Wirshing, Donna A., Wirshing, William C.
• Format: Article
• Language: English
• Subjects: Anticholesteremic Agents - metabolism; Antipsychotic Agents - adverse effects; Biological and medical sciences; Cytochrome P-450 CYP3A; Cytochrome P-450 Enzyme Inhibitors; Cytochrome P-450 Enzyme System - metabolism; Dibenzothiazepines - adverse effects; Drug toxicity and drugs side effects treatment; dyslipidemia; Electrocardiography; Female; Humans; Hyperlipidemias - complications; Hyperlipidemias - drug therapy; Long QT Syndrome - chemically induced; Long QT Syndrome - diagnosis; lovastatin; Lovastatin - metabolism; Lovastatin - therapeutic use; Medical sciences; Middle Aged; Mixed Function Oxygenases - antagonists & inhibitors; Neuropharmacology; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; QTc prolongation; Quetiapine; Quetiapine Fumarate; schizophrenia; Schizophrenia - complications; Schizophrenia - drug therapy; Time Factors; Toxicity: cardiovascular system; Triglycerides - blood; weight
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/S0006-3223(01)01333-6

Background: QTc interval prolongation can occur as a result of treatment with both conventional and novel antipsychotic medications and is of clinical concern because of its association with the potentially fatal ventricular arrhythmia, torsade de pointes. Methods: One case is described in which a patient with schizophrenia, who was being treated for dyslipidemia, developed a prolonged QTc interval while taking quetiapine and lovastatin. Results: QTc returned to baseline when the lovastatin dose was reduced. Conclusions: QTc prolongation associated with antipsychotic medication occurs in a dose-dependent manner. We therefore hypothesize that the addition of lovastatin caused an increase in plasma quetiapine levels through competitive inhibition of the cytochrome P 450 (CYP) isoenzyme 3A4. Our case highlights the potential for a drug interaction between quetiapine and lovastatin leading to QTc prolongation during the management of dysipidemia in patients with schizophrenia.