July 1, 2015Journal of Developmental & Behavioral Pediatrics
A Systematic Evaluation of the QTc Interval and Antidepressants in Youth
Key result
Pediatric antidepressant use shows no link to prolonged QTc intervals.
- n=297
Why the study?
The FDA announced citalopram was associated with dose-related QTc prolongation in adults, but effects of antidepressants on QTc intervals in children were unclear.
Do antidepressants prolong the QTc interval in children aged 5 to 18 years?
Population
297 children aged 5 to 18 years in the Partners Healthcare system with antidepressant or methadone prescription
Comparison
QTc interval per antidepressant compared with mean QTc across all medications
Design
Observational electronic medical record review
Follow-up
14 to 90 days after prescription
Authors
Discussion
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Member takes
Implication
May reassure on QTc safety at standard pediatric doses; leaves open confirmation in prospective or randomized studies.
Study Design
Type
Observational (n=297)
Structured PICO
Do antidepressants prolong the QTc interval in children aged 5 to 18 years?
P
Population
297 children aged 5 to 18 years with an antidepressant or methadone prescription who underwent an electrocardiogram 14 to 90 days after prescription.
E
Exposure
Antidepressants or methadone (including escitalopram, sertraline, and paroxetine)
C
Comparator
Mean of all QTc measurements across all studied medications
O
Outcome
Mean QTc interval per medicationsurrogate
Most antidepressants are not associated with clinically significant QTc prolongation at doses typically prescribed for children.
Cite This Study
Uchida et al. (2015) conducted an observational in Antidepressant or methadone use (n=297). Antidepressants vs. Other antidepressants was evaluated on Mean QTc interval. Antidepressant use in children was not associated with prolonged QTc intervals, with escitalopram showing the highest mean QTc (436 ms) and sertraline the lowest (416 ms).