Incidence of Cardiac Events among Children and Young Adults Exposed to
Psychopharmacological Treatment (2006-2018) - A Nationwide
Register-Based Study.
Abstract
Abstract Aim: 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 0.98% and 0.80%, respectively,
showing significant upward annual trends of 4.26% and 2.48%,
respectively (p<0.001). 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. Sudden death occurred in thirteen
patients. Conclusions: The mean annual incidence of cardiac events among
young patients receiving psychopharmacological treatment was low,
0.98%, with an upward trend of 4.26% annually. Incidence was highest
in 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.