not treated appropriately, but several authors suggest that the exact relationship between prolongation of the QTc interval and the risk of TdP remains elusive [6,7]. Nevertheless, there seems to be a broad consensus that QTc interval > 450-500 ms, and/or QTc prolongation > 60 ms should be used as thresholds requiring increased attention in clinical settings. In addition, physicians should consider cardiovascular risk factors when choosing antipsychotic medications and monitor QTc intervals depending on patient and treatment-related risk factors, as is recommended by the German S3 and British NICE clinical guidelines for the treatment of adults with psychosis or schizophrenia [8,9]. Notably, in both cases corresponding recommendations specific for children and adolescents do not exist.There is some discussion as to the general validity of QTc prolongation in the individual patient due to ECG methodological issues (e.g. diurnal variation in the QTc interval) as well as its risk elevation of cardiovascular adverse events. While some authors argue that QTc prolongation is still the best clinical surrogate marker for TdP risk [10], some others criticize this as an oversimplified statement [11] and some even suggest newer surrogate markers (e.g. T peak -T end [12,13]) for ventricular arrhythmogenesis including drug-induced TdP. Furthermore, drug regulatory bodies and pharmaceutical companies have placed restrictions on some antipsychotic drugs which appear to have a low risk of TdP (for example, quetiapine). Conversely, other drugs with clear evidence of risk have the same level of restriction (for example, amisulpride) [6]. In this context, the definition and weighting of the (above mentioned) cardiovascular risk factors and the resulting effective individual risk for a cardiovascular adverse event are discussed controversially. Some admonitory authors call for a more detailed consideration of the risk of the There are several areas of child and adolescent psychiatry for which the quality and quantity of evidence are substantially lower than for psychiatric care of adults [1][2][3][4]. In this context, one of the most frequently asked questions is about the existence of appropriate and well-regulated pediatric psychopharmacological research to generate evidence as a basis for clinical recommendations [5]. Therefore, concerted efforts to facilitate pediatric psychopharmacological research are claimed again and again without noticeable progress probably because of the (still) limited economic perspectives for sponsors and the various ethical and other concerns and obstacles in investigating children and adolescents. But not only the "generation" of data on pediatric psychopharmacology, but also its "summary and critical evaluation" are still limited.In our personal daily clinical experience in child and adolescent psychiatry, there are a handful of diagnostic and treatment recommendations that are based more on somewhat oversimplified statements from publications on adults than on comprehensive and well-balanced consi...