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QTc Prolongation (Psychiatry)

QTc Safety: Use Fridericia (QTcF) or Bazett (QTcB) corrected values. High risk if QTc > 470-500 ms or multiple risk factors present.

Pro-arrhythmic Risk Screen

Current QTc (ms)

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Baseline and follow-up screening for patients starting QTc-prolonging psychotropics

Risk stratification for Torsades de Pointes (TdP) in the psychiatric population

Identifying modifiable and non-modifiable clinical risk factors (e.g., electrolyte imbalances)

Monitoring patients on polypharmacy involving multiple QTc-active agents

How it Works

Clinical Risk Factors

Sex: Female > Male risk

Age: > 65 years

Electrolytes: Hypokalemia, Hypomagnesemia, Hypocalcemia

Cardiac History: Structural heart disease, Bradycardia

Drugs: Concurrent CYP3A4 inhibitors (e.g., fluoxetine)

QTc Thresholds (Fridericia or Bazett)

Normal (Male/Female)	<430 ms / <450 ms
Borderline	431–450 ms / 451–470 ms
High Risk (Danger)	>500 ms (Associated with 2-3x TdP risk)

Last Comprehensive Review: 2026-07-17