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The relevance of prolonged QTc measurement to pediatric psychopharmacology.

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  • 1Division 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.

PMID:
12921471
[PubMed - indexed for MEDLINE]
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