Torsades de pointes associated with ziprasidone.

Received February 11, 2005; revised June 2, 2005; accepted June 23, 2005. From the Dept. of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI. Send correspondence and reprint requests to Dr. Heinrich, Dept. of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226. e-mail: theinric@mail.mcw.edu 2006 The Academy of Psychosomatic Medicine Medication-induced prolongation of the Q–T interval, which may result in arrhythmias such as torsades de pointes, has long been associated with the antiarrhythmic class of medications. Recently, however, many classes of non-cardiac medications, such as antihistamines, antipsychotics, and antimicrobials, have been associated with secondary Q–T interval prolongation and the risk of torsades de pointes. This potentially deadly treatment complication came to psychiatry’s general attention in the United States with the failed new drug application of sertindole. Sertindole was linked to cases of sudden cardiac death, syncope, and Q–T interval prolongation. The failure of sertindole to make it to the marketplace, coupled with the reports of arrhythmias and sudden cardiac death with other antipsychotics, have ensured that Q–T interval and torsades de pointes will remain a significant clinical issue for psychiatrists for years to come. It is with these important points in mind that we would like to present a case where torsades de pointes developed in a young woman who was being treated with multiple non-cardiac medications, one of which was ziprasidone. This case represents the first report in which torsades de pointes developed in an individual being treated with ziprasidone. This case also underscores the critical importance of communication between consultation psychiatrists, medical consultees, and the patient’s primary psychiatrist. Case Report