Tricyclic medication in children and the QT interval: case report and discussion.
OBJECTIVE
To identify the necessity for close monitoring of the QT interval in children and adolescents treated with tricyclics.


METHODS
Guidelines for permissible ECG changes are reviewed and a case report of a 12-year-old girl with idiopathic long QT syndrome, no history of cardiac disorder, a questionable family history, and normal physical examination and baseline ECG is presented.


RESULTS
Marked increase in QT corrected for heart rate (QTc) occurred on low-dose tricyclic. Possible factors in deaths on desipramine are reviewed.


CONCLUSIONS
It is recommended that children and adolescents on tricyclics receive an ECG at baseline and after each dose increase. Recommendations are made regarding ECG parameters and indications for cardiac consultation.
Alderton
H R
HR
Division of Child Psychiatry, University of Toronto, Ontario.
D000639:Amitriptyline / Q000009:adverse effects / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D000075202:Contraindications; D003891:Desipramine / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004562:Electrocardiography / Q000187:drug effects*; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006801:Humans; D007099:Imipramine / Q000009:adverse effects / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic
D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D009661:Nortriptyline; D007099:Imipramine; D003891:Desipramine