{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:52:13Z","timestamp":1791359533372,"version":"4.3.1"},"reference-count":103,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Antipsychotic\u2010associated heart rate\u2010corrected QT (QTc) prolongation and sudden cardiac death are uncommon in young people, but risk is concentrated in patients with identifiable clinical vulnerability and during selected drug\u2010 or exposure\u2010related situations. We mapped the evidence and developed a risk\u2010stratified framework for clinical monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This structured narrative review searched PubMed in August 2026 using one comprehensive query and 41 targeted subqueries. After PMID\u2010based deduplication, 934 unique records underwent title screening, 382 abstract review, and 158 full\u2010text relevance assessment; 104 database\u2010derived sources met broad relevance criteria. Backward citation checking and author\u2010identified sources added 58 articles. Overall, 162 sources were considered and 100 providing direct, non\u2010redundant support were cited from the original search; three further sources were incorporated during peer review to address reviewer comments, for a final total of 103 cited references. Two authors independently assessed full\u2010text relevance. Youth evidence was prioritized; adult evidence was used for adult\u2010only agents or when youth\u2010specific data were unavailable. Findings were synthesized narratively without formal risk\u2010of\u2010bias or certainty assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patient\u2010level factors, particularly electrolyte disturbance, bradycardia, restrictive eating disorder or medical instability, thyroid dysfunction, inherited channelopathy, structural disease, and interacting drugs, were more consistently associated with QTc risk than drug identity for many commonly used agents. Ziprasidone and pimozide had the strongest youth\u2010specific drug\u2010related signals. Adult evidence supported heightened caution with sertindole and iloperidone; high\u2010dose phenothiazines and amisulpride in overdose or renal impairment represented exposure\u2010 or context\u2010dependent risks. Clozapine required separate myocarditis\u2010focused surveillance. The evidence supports structured baseline risk assessment and targeted ECG and electrolyte testing, with repeat monitoring driven by risk factors, treatment changes, and agent\u2010specific warnings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Monitoring should be tiered rather than uniformly scheduled for all patients. The proposed framework distinguishes core clinical risk assessment from targeted cardiac testing and identifies precautionary intervals that require prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.70146","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:15:41Z","timestamp":1791357341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk\u2010Stratified Cardiac Monitoring During Antipsychotic Treatment in Adolescents and Young Adults"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9211-5248","authenticated-orcid":false,"given":"Alessandro","family":"Cuomo","sequence":"first","affiliation":[{"name":"Department of Molecular and Developmental Medicine University of Siena  Siena 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