When a child needs antipsychotic medication, parents often worry about heart risks. In this real-world study of 430 children and adolescents treated with antipsychotics, clinicians tracked heart rhythms (called ECGs) between 2020 and 2024.
Nearly half of the kids—195 of 429 with usable ECG data—showed at least one minor, numeric heart rhythm change at some point during follow-up. A smaller group, 24 patients (about 5.6%), had a specific change called QTc prolongation, which can signal a higher risk for dangerous rhythms. In five of those 24 kids, the change persisted. Importantly, no one had a severely prolonged QTc (≥500 ms), and no one had serious arrhythmias, high-grade conduction problems, or sudden cardiac events.
The researchers also looked for patterns—like age, sex, using multiple antipsychotics, or adding other QT-prolonging drugs—and found no clear links to QTc changes. Because this was a single-center, observational study without a control group, we can’t say antipsychotics caused these ECG changes. Specific drug and dose data weren’t reported, so we don’t know how different medications or dosages might influence risk. Still, the findings suggest ECG abnormalities were mostly mild and transient, and serious heart events were absent in this group.