The relevance of prolonged QTc measurement to pediatric psychopharmacology.
OBJECTIVE
To consider the relevance of prolonged QTc (QT interval corrected for rate) to pediatric psychopharmacology.


METHODS
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.


CONCLUSIONS
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.
Labellarte
Michael J
MJ
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287-3325, USA. labellartemd@earthlink.net
Crosson
Jane E
JE
Riddle
Mark A
MA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D003645:Death, Sudden / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis*; D008297:Male; D010372:Pediatrics; D011600:Psychopharmacology; D011619:Psychotropic Drugs / Q000009:adverse effects; D012107:Research Design; D016171:Torsades de Pointes / Q000209:etiology
D011619:Psychotropic Drugs