QTc-verlenging door antipsychoticagebruik binnen de kinder- en jeugdpsychiatrie: een systematische literatuurstudie

Abstract

QTc prolongation associated with antipsychotic treatment in child and adolescent psychiatry: a systematic review Antipsychotics play a significant role in the treatment of psychiatric disorders. Monitoring of metabolic dysregulation and cardiac rhythm disturbances is essential. Given that the pharmacokinetic profile of children differs from that of adults, the literature cannot be extrapolated without consideration. Therefore, a systematic review on the risk of QTc prolongation in minors receiving antipsychotic treatment was conducted. The literature review was conducted within PubMed, Embase and Web of Science, focusing on randomized controlled trials (RCTs). Antipsychotics were selected based on the Belgian and Dutch formulary for the treatment of psychiatric disorders in minors. The study included 28 RCTs that examined the effect and safety of antipsychotic treatment in minors, including cardiac risks. The occurrence of clinically relevant QTc prolongation development is relatively rare. The comparison of the results was hindered by differences in the acquisition and correction of electrocardiograms (ECGs). It is advisable to identify risk factors through history-taking and blood sampling. Current research indicates that the risk of QTc prolongation and torsade de pointes in minors receiving antipsychotic treatment is relatively rare. However, vigilance is warranted in the presence of specific risk factors, in which case ECG monitoring is recommended.