Thiordazine (Mellaril？？) hydrochloride cardiotoxicity is manifested by prolongation of the QT interval, flattening of the ST segment and inversion of the T wave. The lethal ventricular tachycardia is initiated by reentrance of ectopic beat during the prolonged QT interval which is more accentuated by hypothyroidism. Lidocaine infusion, which shortens QT interval and increases conduction velocity, is the drug of choice in case of ventricular tachycardia. Major cardiac arrhythmia including ventricular tachycardia is a hazard in patients without heart disease who are receiving customary therapeutic dose of thioridazine. Especially in case of a patient with hypothyroidism, thioridazine should be used with caution even if it is usual therapeutic dose.
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