Research Article QT and QTc in Male Patients with Psychotic Disorders Treated with Atypical Neuroleptics Mario Miniati, Marly Simoncini, Federica Vanelli, Caterina Franceschini, Gabriele Massimetti, Claudia Carmassi, and Liliana Dell’Osso Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Correspondence should be addressed to Mario Miniati; mario.miniati@med.unipi.it Received 21 March 2017; Revised 5 June 2017; Accepted 11 June 2017; Published 12 July 2017 Academic Editor: Rajesh R. Tampi Copyright © 2017 Mario Miniati et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. We explored the potential association between antipsychotics and QT/QTc duration changes in hospitalized male patients with psychotic disorders. Methods. Te chart review was conducted on 184 male patients hospitalized between 2013 and 2015 at the Psychiatric Clinic of Pisa, Italy. Patients who were treated with one atypical antipsychotic at the time of the ECG recording were 109/184 (59.2%). QT/QTc were compared considering the atypical antipsychotic received. Results. 96.3% (n = 105/109) of the sample showed QTc values ≤ 430 ms; 4 patients (3.7%) had QTc values between 430 and 450 msec (2 with paliperidone, 1 with risperidone, and 1 with olanzapine). Te mean QT duration of the overall sample was 368.0 ± 28.0 and the mean QTc 400.1 ± 17.8. QTc values did not reveal statistically signifcant diferences. QT values were signifcantly diferent (chi-square = 17.3; df = 5; p = .004). Statistically signifcant diferences between aripiprazole and paliperidone (349.0 ± 28.3 versus 390.5 ± 29.8; p = .002) and between clozapine and paliperidone (361.1 ± 22.43 versus 390.5 ± 29.8; p = .033) were found. Conclusions. Aripiprazole was the least interfering neuroleptic with QT/QTc. Paliperidone was the atypical neuroleptic with the most relevant diference with aripiprazole, but only on QT. 1. Introduction Te prevalence of cardiovascular diseases is high in patients with Psychotic Disorders for a number of reasons, including continued antipsychotic therapy, especially combined ther- apy with more than one antipsychotic or with other agents [1]. Several physiologic cardiovascular efects are associated with the action mechanism of antipsychotics. For example, the 1 adrenergic blockade can raise the risk of syncope or hypotension with an increased incidence of angina episodes [2]. However, one of the most relevant cardiovascular side efects of antipsychotics is QT prolongation [3]. Te electrical action of the heart has two components: depolarization, or the stage before the peak of the cardiac wave that leads to the contraction of the heart muscle, and repolarization, the stage in which the heart recharges for the next beat and the heart muscle relaxes. Te QT interval is the time during which the system repolarizes. Since this interval depends on heart rate, it is usually measured and reported as the corrected QT interval (QTc). Reference points for normal, borderline, and prolonged QTc are well known [4]. Normal QTc interval is <430 msec for males and <450 msec for females; borderline interval is 431–450 msec for males and 451–470 msec for females; a prolonged QTc interval is considered >450 msec for males and >470 msec for females [4]. If a patient has a borderline QTc, he/she should be assessed at baseline and intermittently afer initiation when prescribing any antipsychotic [3]. Moreover, patients whose QTc has increased by 60 msec during antipsychotic treatment would also need to be monitored closely [5]. A number of antipsychotics have led to concern about QT changes. Sertindole was never marketed in the US [6]; mesoridazine was marketed in the US but with a warning regarding dose-related QTc prolongation and associated risk of torsade de pointes [6]. Te introduction of ziprasidone was delayed in the US because of concerns about QTc lengthening [7]. Although these drugs are all antipsychotics, they had diferent side efect profles, receptor afnities, and mechanisms of action, thus emphasizing the difculties in making generalizations about them. Moreover, two risk Hindawi e Scientific World Journal Volume 2017, Article ID 1951628, 5 pages https://doi.org/10.1155/2017/1951628