The QT interval and psychotropic medications in children: recommendations for clinicians.
The use of psychotropic medications in children has increased significantly in the last few years. There have been several case reports of sudden death in children taking specific psychotropic medications. Fears that these deaths might have been caused by ventricular arrhythmias have been enhanced by reports of electrocardiographic abnormalities, including prolongation of the QTc interval, in patients taking these medications. Several factors including genetic susceptibility, pre-existing cardiac disease, abnormalities of drug clearance and concomitant use of other medications known to affect the QTc interval can increase the susceptibility of the heart to conduction abnormalities. This article discusses the potential of particular psychotropic drugs to prolong the QTc interval in children, and examines other factors that may contribute to conduction abnormalities. We aim to provide clear clinical recommendations for the prescription of these drugs and the monitoring of children taking them.
McNally
Paul
P
Department of Paediatric Cardiology, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland.
McNicholas
Fiona
F
Oslizlok
Paul
P
D000200:Action Potentials / Q000187:drug effects; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002648:Child; D003577:Cytochrome P-450 Enzyme System / Q000187:drug effects / Q000378:metabolism; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced; D008297:Male; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012016:Reference Values
D011619:Psychotropic Drugs; D003577:Cytochrome P-450 Enzyme System