Michael J Labellarte1, Jane E Crosson, Mark A Riddle. 1. Division of Child and Adolescent Psychiatry, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287-3325, USA. labellartemd@earthlink.net
Abstract
OBJECTIVE: To consider the relevance of prolonged QTc (QT interval corrected for rate) to pediatric psychopharmacology. METHOD: The authors reviewed publications on QTc prolongation and publications on sudden death in Medline from 1968 to November 2002. RESULTS: The search yielded more than 20,000 publications. Review manuscripts with clinical recommendations outnumber the few pediatric studies of QTc duration during treatment. Most reviews have been published in the past 5 years, during a time when the Food and Drug Administration restricted five psychotropic medications because of QTc prolongation (sertindole: not approved; thioridazine, mesoridazine, and droperidol: black-box warning; and ziprasidone: bolded warning) and nine somatic medications because of QTc prolongation. CONCLUSION: Pretreatment screening, careful selection of psychotropic and/or somatic medication combinations, and recognition of QTc prolongation in electrocardiographic tracings during treatment with medications that prolong QTc are important components of clinical practice.
OBJECTIVE: To consider the relevance of prolonged QTc (QT interval corrected for rate) to pediatric psychopharmacology. METHOD: The authors reviewed publications on QTc prolongation and publications on sudden death in Medline from 1968 to November 2002. RESULTS: The search yielded more than 20,000 publications. Review manuscripts with clinical recommendations outnumber the few pediatric studies of QTc duration during treatment. Most reviews have been published in the past 5 years, during a time when the Food and Drug Administration restricted five psychotropic medications because of QTc prolongation (sertindole: not approved; thioridazine, mesoridazine, and droperidol: black-box warning; and ziprasidone: bolded warning) and nine somatic medications because of QTc prolongation. CONCLUSION: Pretreatment screening, careful selection of psychotropic and/or somatic medication combinations, and recognition of QTc prolongation in electrocardiographic tracings during treatment with medications that prolong QTc are important components of clinical practice.
Authors: Daniel A Gorman; David M Gardner; Andrea L Murphy; Mark Feldman; Stacey A Bélanger; Margaret M Steele; Khrista Boylan; Kate Cochrane-Brink; Roxanne Goldade; Paul R Soper; Judy Ustina; Tamara Pringsheim Journal: Can J Psychiatry Date: 2015-02 Impact factor: 4.356