Evidence map›Paper›PMID 39549076›Full record

SynthesisEuropean journal of pediatrics2024

Cardiac safety of antipsychotic medications in pediatric and adolescent population: a systematic review and pathways for future research.

Simone Gasparini, Sara Senese, Erica Scuma, Fabiana Parodi, Arianna Gianfredi, Sara Ciabattini, Viviana Loddo, Giulio Peroni, Giulio Porcedda, Tiziana Pisano

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Supraventricular Tachycardia in an Adolescent with Acute Psychotic Disorder Treated with Olanzapine: A Rare Event Managed with Aripiprazole.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Simone GaspariniChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Sara SeneseChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Erica ScumaChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Fabiana ParodiChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Arianna GianfrediChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Sara CiabattiniChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Viviana LoddoChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Giulio PeroniChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy.
Giulio PorceddaDepartment of Paediatric Cardiology, Meyer Children's Hospital IRCCS, 50139, Florence, Italy.
Tiziana PisanoChild and Adolescent Psychiatry Unit, Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS 50139, Florence, Italy. t.pisano@meyer.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Understanding the cardiac risks of antipsychotic use is crucial for clinicians managing psychiatric conditions in children and adolescents. However, the effects on the QT interval in pediatric populations have been poorly investigated. We performed a systematic review to provide clinicians an updated source on the effects of antipsychotic medications on QTc and guide drug's choice. A literature search on the PubMed and Scopus databases was conducted from April 22, 1989, to May 28, 2023, for all studies investigating the effects of antipsychotic medications on the QTc interval in patients aged 0-18 years. A total of 10 articles including 523 patients and 7 different antipsychotic drugs met our search criteria. Among the included articles were three randomized clinical trials, five controlled trials without randomization or prospective comparative cohort trials, and two retrospective cohort studies. Clinical data emerging from these studies were classified according to the Oxford Centre for Evidence-Based Medicine. Risperidone and aripiprazole showed minimal to no significant QTc prolongation, whereas quetiapine, olanzapine, and ziprasidone showed variable effects on QTc. Haloperidol did not demonstrate significant QTc prolongation. In a prospective comparative cohort trial, pimozide exhibited significant QTc prolongation in a cohort with Tourette syndrome.

conclusionOnly 10 studies have carefully addressed the effect of antipsychotic medications on QTc among pediatric patients, underscoring the need for further research. Personalized risk assessment and regular cardiac monitoring should be integrated into clinical management of pediatric and adolescent patients receiving antipsychotics to facilitate early detection of repolarization abnormalities and potential intervention. WHAT IS KNOWN: • QT interval prolongation is a reported side effect of antipsychotics among adults especially with first-generation antipsychotics and parenteral infusion. • Understanding the effect of antipsychotics on QT is essential for clinical monitoring and avoidance of complications. WHAT IS NEW: • Risperidone and aripiprazole were the most studied antipsychotics in pediatric patients and showed minimal QT prolongation. • The absence of a standardized protocol for assessing the effects on the QT interval makes comparisons between studies challenging and emphasizes the need for further research.

Indexed as

Antipsychotic AgentsLong QT SyndromeAdolescentChildChild, PreschoolHumansInfantAntipsychotic AgentsAntipsychoticsAripiprazoleECGPediatricsQTcRisperidone

Identifiers

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.