title: A Pilot Study: Cardiac Parameters in Children Receiving New-Generation Antidepressants.
abstract: OBJECTIVE
  Because of concerns about potential associations between high doses of citalopram and QTc prolongation in adults, this study examined whether such associations are operant in children. We hypothesized that therapeutic doses of nontricyclic antidepressant medications (non-TCAs) prescribed to children would be cardiovascularly safe.
  
  
  METHODS
  The sample consisted of 49 psychiatrically referred children and adolescents 6 to 17 years old of both sexes treated with a non-TCA (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, bupropion, duloxetine, venlafaxine, mirtazapine). To standardize the doses of different antidepressants, we converted doses of individual medicines into "citalopram equivalent doses" (CEDs) based on dosing recommendation for individual antidepressants. Correlation analysis was carried out to compare the continuous and weight-based CED to variables of interest. A QTc grouping was defined as normal, borderline, or abnormal, and CED was compared across QTc groupings using linear regression. An antidepressant dosage group was defined as low or high dose, and a t test compared variables of interest across dosage groups.
  
  
  RESULTS
  No significant associations were found between total or weight-corrected CEDs of any antidepressant examined and QTc or any other electrocardiogram or blood pressure parameters. In patients taking citalopram or escitalopram, a significant correlation was found between PR interval and total daily dose, which disappeared when weight-based doses were used or when corrected by age.
  
  
  CONCLUSIONS
  Although limited by a relatively small sample size, these results suggest that therapeutic doses of non-TCA antidepressants when used in children do not seem to be associated with prolonged QTc interval or other adverse cardiovascular effects.
authors.affiliation: From the *Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital; and †Pediatric Cardiology, Massachusetts General Hospital for Children, Boston, MA.
authors.forename: Mai
authors.initials: M
authors.lastname: Uchida
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Spencer
authors.forename: Tara
authors.initials: T
authors.lastname: Kenworthy
authors.forename: James
authors.initials: J
authors.lastname: Chan
authors.forename: Maura
authors.initials: M
authors.lastname: Fitzgerald
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Rosales
authors.forename: Elana
authors.initials: E
authors.lastname: Kagan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Saunders
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced; D008297:Male; D010865:Pilot Projects
chemical_list: D018687:Antidepressive Agents, Second-Generation