Cardiovascular Effects of Therapeutic Doses of Tricyclic Antidepressants in Children and Adolescents

"poison control center" to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. RESULTS:According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. CONCLUSIONS:Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research.

show abstract

“…95,96 As with the ADHD stimulants, the combined effects of energy drinks and antidepressants are unknown. 94 …”

Section: Effects Of Energy Drinks On Children and Adolescents With Adhdmentioning

confidence: 99%

Health Effects of Energy Drinks on Children, Adolescents, and Young Adults

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The drug has therefore been withdrawn in some countries. Desipramine, like other tricyclics, should be seen as having a cardiotoxic potential that varies greatly between children [180]. When they are prescribed, then children should have pulse, blood pressure and ECG monitoring at baseline, after each dose increase and then every 3 months.…”

Section: ■ Other Drugsmentioning

confidence: 99%

European clinical guidelines for hyperkinetic disorder ? first upgrade

Taylor

Döpfner

Sergeant

et al. 2004

European Child & Adolescent Psychiatry

500

452

View full text Add to dashboard Cite

■ Abstract Background The validity of clinical guidelines changes over time, because new evidencebased knowledge and experience develop. Objective Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified. Method Discussions at the European Network for Hyperkinetic Disorders (EUNETHYDIS) and iterative critique of each clinical analysis. Guided by evidence-based information and based on evaluation (rather than metaanalysis) of the scientific evidence a group of child psychiatrists and psychologists from several European countries updated the guidelines of 1998. When reliable information is lacking the group gives a clinical consensus when it could be found among themselves. Results The group presents here a set of recommendations for the conceptualisation and management of hyperkinetic disorder and attention deficit/hyperactivity disorder (ADHD). Conclusion A general scheme for practice in Europe could be provided, on behalf of the European Society for Child and Adolescent Psychiatry (ESCAP).

show abstract

“…The QTc was considered prolonged if >440 msec, regardless of gender, as recommended in the cardiology and pharmacological literature (Moss 1993;Haddad and Anderson 2002) and used in studies of children treated with tricyclic antidepressants (Wilens et al 1996) and ziprasidone (Blair et al 2005). This unisex threshold is at variance with findings from a community-based representative North American population that demonstrated a drop of 20 msec in QTc duration in adolescent males after puberty (Rautarhaju et al 1992), but was used by us to allow comparisons with previous studies.…”

Section: Journal Of Child and Adolescent Psychopharmacologymentioning

confidence: 99%

Antipsychotic Drug Administration Does Not Correlate with Prolonged Rate-Corrected QT Interval in Children and Adolescents: Results from a Nested Case–Control Study

Correll

Harris²,

Figen³

et al. 2011

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

Background: The rate-corrected QT interval (QTc) prolongation is a risk factor for sudden cardiac death and may be induced by antipsychotic drugs. Objective: To determine the clinical characteristics associated with QTc prolongation (440 msec or greater) in children and adolescents hospitalized for treatment of psychiatric disorders. Method: We determined the frequency of baseline prolongation of QTc in 811 psychiatric pediatric inpatients (15.5 AE 2.4 years of age). QTc duration was 440 msec or greater (range 441-481 msec) in 16 patients (1.97%). In a 1:5 nested case-control design, the 16 patients with prolonged QTc were age-and gender-matched with 80 patients with QTc of <421 msec. Results: Patients with normal and prolonged QTc had similar utilization of antipsychotics (43.8% vs. 40.8%) and daily chlorpromazine equivalents (165 AE 110 vs. 168 AE 218 mg). Hypokalemia ( p ¼ 0.009) and obesity ( p ¼ 0.032) were more common among patients with prolonged QTc. The correlation between obesity and QTc prolongation was confirmed in logistic regression analysis. Conclusions: In a large cohort of youth hospitalized for treatment of psychiatric disorders, a prolonged QTc on admission was rare and correlated with the presence of obesity, but not with current use of antipsychotic drugs.

show abstract

Cardiovascular Effects of Therapeutic Doses of Tricyclic Antidepressants in Children and Adolescents

Cited by 290 publications

References 58 publications

Health Effects of Energy Drinks on Children, Adolescents, and Young Adults

Health Effects of Energy Drinks on Children, Adolescents, and Young Adults

European clinical guidelines for hyperkinetic disorder ? first upgrade

Antipsychotic Drug Administration Does Not Correlate with Prolonged Rate-Corrected QT Interval in Children and Adolescents: Results from a Nested Case–Control Study

Contact Info

Product

Resources

About