Citalopram, QTc Prolongation, and Torsades de Pointes

Tampi, Rajesh R.; Balderas, Michael; Carter, Kathleen V.; Tampi, Deena J.; Moca, Marian; Knudsen, Amy B.; May, J B

doi:10.1016/j.psym.2014.09.002

Cited by 36 publications

(24 citation statements)

References 35 publications

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“…Patients may also develop QT-HR abnormalities, which may be considered a risk for torsades de pointes [6,27]. In our present study, 18% and 11% of patients presented with tachycardia and bradycardia, respectively, although none of the patients developed prolonged QTc that was above the normal range.…”

Section: Discussionsupporting

confidence: 44%

Investigation of the Clinical Significance of Escitalopram-Induced Electrocardiographic Changes in Men: A Pilot Observational Study

Almeman

Altwijri

Alsaif

et al. 2019

Int J Pharm Pharm Sci

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Objective: We sought to investigate the clinical significance of secondary electrocardiographic (ECG) changes in men after using escitalopram. Methods: This pilot observational cohort study recruited male patients taking escitalopram for at least 6 mo in Mental Hospital of Qassim. All patients underwent a 12-lead ECG examination. We also measured the heart rate (HR), QTc, and QRS interval. Data on all related medical conditions and medications were recorded. Results: Fifty-three men were recruited, with a mean age of 37.39±8.39 y: 34.4% and 31.1% of these patients were taking escitalopram for depression and anxiety, respectively. The mean dose of escitalopram was 14.35 mg. Observations showed that 20.9% of the patients taking escitalopram had a fast HR (>100 beats/min [bpm]), indicative of sinus tachycardia, whereas 11.4% of patients had a slow HR (<60 bpm). The mean QT and QTc in patients taking escitalopram were 366.62±28.69 and 398.92±16.15 ms, respectively. Conclusion: Low doses of escitalopram resulted in minimal clinically significant changes. Thus, patients should be monitored when doses are escalated further.

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Section: Discussionsupporting

confidence: 44%

Investigation of the Clinical Significance of Escitalopram-Induced Electrocardiographic Changes in Men: A Pilot Observational Study

Almeman

Altwijri

Alsaif

et al. 2019

Int J Pharm Pharm Sci

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show abstract

“…36,49,50 This observation also highlights the complexity behind the diverse and often contradictory effects of 5HT-receptor agonists, probably through binding to different receptors. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Dysphagia, however, may not solely arise from the esophagus or the LES but from a more proximal site, as well.…”

Section: Discussionmentioning

confidence: 99%

Effect of citalopram on esophageal motility in healthy subjects—Implications for reflux episodes, dysphagia, and globus

Manolakis

Broers

Geysen

et al. 2019

Neurogastroenterology Motil

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Background Drugs such as citalopram, “targeting” the serotonin pathway, can alter esophageal mechano‐chemical sensitivity and gastrointestinal motility. The aim of this study was to clarify the effect of citalopram on esophageal motility and sphincter function, transient lower esophageal sphincter relaxations (TLESRs), and reflux events. Methods Sixteen healthy volunteers (HV) receiving 20 mg citalopram or placebo intravenously, in a randomized cross‐over fashion, underwent two high‐resolution impedance manometry studies involving liquid swallows and a high‐fat, high‐caloric meal. Manometric, reflux, and symptom‐related parameters were studied. Key Results A lower distal contractile integral was recorded under citalopram, compared with placebo (P = 0.026). Upper esophageal sphincter (UES) resting pressure was significantly higher after citalopram administration throughout the study (P < 0.05, all periods). Similarly, the UES postswallow mean and maximum pressures were higher in the citalopram condition (P < 0.0001, in both cases) and this was also the case for the 0.2 s integrated relaxation pressure (P = 0.04). Esophagogastric junction resting pressures in the citalopram visit were significantly higher during swallow protocol, preprandial period, and the first postprandial hour (P < 0.05, in all cases). TLESRs and total reflux events were both reduced after citalopram infusion (P = 0.01, in both cases). During treatment with citalopram, five participants complained about globus sensation (P = 0.06). This citalopram‐induced globus was associated with higher UES postswallow mean and maximum pressure values (P = 0.01 and P = 0.04, respectively). Conclusions and Inferences Administration of citalopram exerts a diversified response on esophageal motility and sphincter function, linked to clinically relevant phenomena: a reduction in postprandial TLESRs and the induction of drug‐induced globus.

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“…Fluok se ti nas, pa rok se ti nas ir ser tra li nas pri ski ria mi vais tams, ne su ke lian tiems reikð min go QTc pail gë ji mo, kai yra ski ria mi re ko men duo ja mo mis do zë mis ir në ra ki tø ri zi kos fak to riø. Pa skelb ta áro dy mø, kad ci talop ra mas ga li il gin ti QTc [24], to dël re ko men duo ja ma neskir ti di des nës nei 40 mg ci ta lop ra mo pa ros do zës, ne skir ti ðio vais to pa cien tams su ágim tu il gu QT ir nu trauk ti sky rimà, kai QTc -> 500 ms, taip pat skir ti dvi gu bai ma þes nes mak si ma lias do zes pa cien tams, ku riems yra dau giau nei 65 m. [25]. Es ci ta lop ra mas ma þiau il gi na QTc in ter va là nei ci ta lop ra mas.…”

Section: Elektrofiziologiniai Pokyèiai Ir Aritmijosunclassified

Effects of neuroleptics and antidepressants on the cardiovascular system: literature review

Rutkauskas¹

2019

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Didelė dalis antidepresantų ir neuroleptikų, vartojamų psichikos sutrikimams gydyti, gali sukelti reikšmingų ir potencialiai mirtinų širdies ir kraujagyslių sistemos funkcijos sutrikimų. Prieš skiriant šiuos vaistus, svarbu įvertinti paciento širdies ir kraujagyslių sistemos ligų riziką ir atsižvelgti į ją, renkantis tinkamiausią gydymą. Šiame apžvalginiame straipsnyje pateikiami literatūros duomenys apie antidepresantų ir neuroleptikų poveikį arteriniam kraujospūdžiui, elektrofiziologiniams širdies raumens pokyčiams, širdies raumens ligų ir išeminės širdies ligos atsiradimui.

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Citalopram, QTc Prolongation, and Torsades de Pointes

Cited by 36 publications

References 35 publications

Investigation of the Clinical Significance of Escitalopram-Induced Electrocardiographic Changes in Men: A Pilot Observational Study

Investigation of the Clinical Significance of Escitalopram-Induced Electrocardiographic Changes in Men: A Pilot Observational Study

Effect of citalopram on esophageal motility in healthy subjects—Implications for reflux episodes, dysphagia, and globus

Effects of neuroleptics and antidepressants on the cardiovascular system: literature review

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