依西酞普兰
西酞普兰
文拉法辛
抗抑郁药
QT间期
舍曲林
安非他酮
米氮平
医学
再摄取抑制剂
氟西汀
帕罗西汀
加药
心理学
麻醉
内科学
血清素
受体
戒烟
病理
海马体
作者
Mai Uchida,Andrea E. Spencer,Tara Kenworthy,James Chan,Maura Fitzgerald,Ana M. Rosales,Elana Kagan,Alexandra Saunders,Joseph Biederman
标识
DOI:10.1097/jcp.0000000000000683
摘要
Abstract Objective Because of concerns about potential associations between high doses of citalopram and QTc prolongation in adults, this study examined whether such associations are operant in children. We hypothesized that therapeutic doses of nontricyclic antidepressant medications (non-TCAs) prescribed to children would be cardiovascularly safe. Study Design The sample consisted of 49 psychiatrically referred children and adolescents 6 to 17 years old of both sexes treated with a non-TCA (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, bupropion, duloxetine, venlafaxine, mirtazapine). To standardize the doses of different antidepressants, we converted doses of individual medicines into “citalopram equivalent doses” (CEDs) based on dosing recommendation for individual antidepressants. Correlation analysis was carried out to compare the continuous and weight-based CED to variables of interest. A QTc grouping was defined as normal, borderline, or abnormal, and CED was compared across QTc groupings using linear regression. An antidepressant dosage group was defined as low or high dose, and a t test compared variables of interest across dosage groups. Results No significant associations were found between total or weight-corrected CEDs of any antidepressant examined and QTc or any other electrocardiogram or blood pressure parameters. In patients taking citalopram or escitalopram, a significant correlation was found between PR interval and total daily dose, which disappeared when weight-based doses were used or when corrected by age. Conclusions Although limited by a relatively small sample size, these results suggest that therapeutic doses of non-TCA antidepressants when used in children do not seem to be associated with prolonged QTc interval or other adverse cardiovascular effects.
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