Management of Patients on QT Prolonging Psychiatric Medication

Clinicians managing patients on QT prolonging psychiatric medication should obtain a baseline ECG before initiating the medication, repeat it after the drug reaches a steady state in 2-3 days, and consider repeating if patients develop symptoms like palpitations, syncope, chest pain, or shortness of breath. Baseline electrolytes should also be obtained and repeated once the drug reaches a steady state and annually thereafter. If the QT interval on ECG is between 470-500 milliseconds for males or 480-500 milliseconds for females, clinicians should consider switching to a non-QT prolonging agent or reducing the medication dose.