Use of phenothiazines as sedatives in children: what are the risks?

Phenothiazines have been widely used for their antiemetic, antipsychotic and sedative properties for many years. The introduction of alternative agents for paediatric sedation has led to the re-evaluation of phenothiazines as paediatric sedatives. Newer agents, such as fentanyl and midazolam, have short half-lives and reversal agents are available. Therefore these agents may offer comparable therapeutic efficacy with a better safety profile in young children. Reports of sudden infant death syndrome in children receiving a phenothiazine-containing syrup for symptoms of upper respiratory infection means that the outpatient use of these compounds in very young infants is not recommended.