INTRODUCTION Drug-induced QT prolongation is associated with higher cardiovascular mortality. MATERIAL AND METHODS We conducted a protocol-based comprehensive review of antidepressant-induced QT prolongation in people with mental disorders. RESULTS Based on findings from 47 published randomized controlled trials (RCTs), 3 unpublished RCTs, 14 observational studies, 662 case reports of torsades de pointes, and 168 cases of QT prolongation, we conclude that all antidepressants should be used only with licensed doses, and that all patients receiving antidepressants require monitoring of QT prolongation and clinical symptoms of cardiac arrhythmias. Large observational studies suggest increased mortality associated with all antidepressants (RR = 1.62, 95% CI: 1.60-1.63, number of adults: 1,716,552), high doses of tricyclic antidepressants (OR = 2.11, 85% CI 1.10-4.22), selective serotonin reuptake inhibitors (OR = 2.78, 95% CI: 1.24-6.24), venlafaxine (OR = 3.73, 95% CI: 1.33-10.45, number of adults: 4,040), and nortriptyline (OR = 4.60, 95% CI: 1.20-18.40, number of adults: 5,298). CONCLUSIONS Evidence regarding the risk of QT prolongation in children is sparse.

中文翻译：

---

抗抑郁药对精神障碍患者 QT 间期的影响。

引言 药物引起的 QT 延长与较高的心血管死亡率相关。材料和方法 我们对精神障碍患者中抗抑郁药引起的 QT 间期延长进行了基于方案的综合评价。结果 基于 47 项已发表的随机对照试验 (RCT)、3 项未发表的 RCT、14 项观察性研究、662 例尖端扭转型室性心动过速病例报告和 168 例 QT 延长的结果，我们得出结论，所有抗抑郁药都应仅在许可剂量下使用，并且所有接受抗抑郁药的患者都需要监测 QT 间期延长和心律失常的临床症状。大型观察性研究表明，所有抗抑郁药（RR = 1.62，95% CI：1.60-1.63，成人人数：1,716,552）、高剂量三环类抗抑郁药（OR = 2.11，85% CI 1.10-4.22），选择性5-羟色胺再摄取抑制剂（OR = 2.78，95% CI：1.24-6.24），文拉法辛（OR = 3.73，95% CI：1.33-10.45，成人人数：4,040）和去甲替林（ OR = 4.60，95% CI：1.20-18.40，成人人数：5,298）。结论 关于儿童 QT 间期延长风险的证据很少。