Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic psychiatric disorders. However, antipsychotics have been associated with higher rates of mortality due to their cardiovascular risk factors, such as QT prolongation. This study aimed to determine the association between cumulative dose of antipsychotics (first and second-generation) and QT prolongation, [...]

Background: It is common practice to monitor QTc interval in hospitalized patients newly started on antipsychotics. While some guidelines exist for frequency of ordering EKGs in the outpatient setting, these may not apply to inpatients due to comorbid electrolyte disturbances or addition of other new medications. There are no evidence-based guidelines for QTc monitoring frequency [...]

Background: Antipsychotics can prolong QTc interval and lead to development of the fatal arrhythmia Torsade de Pointes. Accordingly, serial EKG monitoring of QTc in patients newly started on antipsychotics has become common practice in hospitals. By current standards, medical management of antipsychotic therapy is clinically indicated when QTc > 500ms and/or there is an increase [...]

Case Presentation: A 47-year-old woman with migraines, bipolar disorder, and hypothyroidism presented with a 2-day headache that was not improving with sumatriptan. She also complained of generalized weakness, dizziness, nausea, and vomiting. Workup revealed diabetic ketoacidosis, with blood glucose 530 mg/dL, venous pH 7.02, bicarbonate of 8 mmol/L, and anion gap 29. The patient had [...]