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Incidence and trend of cardiac events among children and young adults exposed to psychopharmacological treatment (2006–2018): A nationwide register-based study
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Department of Drug Treatment, Sahlgrenska University Hospital, Västra Götaland, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland; Research Centre for Child Psychiatry and INVEST-flagship, University of Turku, Turku, Finland.
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2024 (English)In: British Journal of Clinical Pharmacology, ISSN 0306-5251, E-ISSN 1365-2125Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims: The aim of this study was to assess cardiac event incidence and trends by sex and age in young patients on psychopharmacological treatment in Sweden.

Methods: This nationwide incidence study encompassed data from Swedish registers (2006–2018). Patients aged 5–30 years were exposed to one or more psychotropic medications (attention deficit hyperactivity disorder medications, antihistamines, selective serotonin reuptake inhibitors, other antidepressants, anxiolytics, antipsychotics, hypnotics/sedatives). Annual incidences, trends and mean incidences of cardiac events (cardiac arrest, arrhythmias, fainting/collapse, sudden death) and recurrent events were calculated.

Results: Among those exposed (n = 875 430, 2 647 957 patient-years, 55% female), 26 750 cardiac events were identified. The mean annual incidence of cardiac events and first-ever events were 0.99% and 0.80%, respectively, showing significant upward annual trends of 4.26% and 2.48%, respectively (P <.001). The highest incidences were among females aged 15–19 years (1.50%) and those exposed to polypharmacy (1.63%), anxiolytics (1.53%) or antihistamines (1.27%). The mean annual incidences of cardiac arrest and arrythmias, for both sexes, were 0.01% and 0.51%, respectively. Fainting/collapse accounted for about half of all events, occurring more often in females. The pattern of rising annual incidence remained after excluding fainting/collapse. In all, 21.1% of events were recurrent. Death, including sudden death, occurred in 13 patients.

Conclusions: The mean annual incidence of cardiac events among young patients receiving psychopharmacological treatment was low, 0.99%, with an upward trend of 4.26% annually. Incidence was highest in adolescent females and patients exposed to polypharmacy. Our study highlights the need for more knowledge regarding the possible association between exposure to psychopharmacological treatment and cardiac events.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024.
Keywords [en]
cardiac arrest, death, paediatric arrhythmias, psychotropic medications
National Category
Pharmacology and Toxicology
Identifiers
URN: urn:nbn:se:umu:diva-231554DOI: 10.1111/bcp.16321ISI: 001341175600001PubMedID: 39448545Scopus ID: 2-s2.0-85207589022OAI: oai:DiVA.org:umu-231554DiVA, id: diva2:1914623
Available from: 2024-11-20 Created: 2024-11-20 Last updated: 2024-11-20

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Elmowafi, HowaidaHalldner, LindaNaumburg, Estelle

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