Managing the risk of torsades de pointe when prescribing antipsychotic medication

Antipsychotic medications are widely prescribed by advanced clinical practitioners (ACPs), to treat a range of presentations. They are licensed for the treatment of schizophrenia, bipolar disorder and depression. They are also widely used off-license as anxiolytics, as well as to help manage presenting symptoms of borderline personality. These drugs are associated with prolonged QT interval, which is a risk factor for the ventricular tachyarrhythmia, torsades de pointes (TdP), which can lead to sudden cardiac death. Although TdP is rare, this review examines the condition and discusses the importance of assessing the physical, pharmacological and psychiatric risks prior to prescribing antipsychotic medications.