Should We be Worried About QTc Prolongation Using Citalopram? A Review

J Pharm Pract. 2017 Jun;30(3):353-358. doi: 10.1177/0897190015624862. Epub 2016 Jan 13.

Abstract

Purpose: Summarize available information regarding clinical impact of citalopram on the QTc interval.

Methods: A literature search was conducted in Pubmed, EMBASE, and Cochrane databases using the MeSH term "long QT syndrome" and key word "citalopram" on July 11, 2014.

Results: Thirty-one studies were evaluated with 4 included in this review. Studies were excluded if they reported acute overdoses of citalopram or did not report on patient-specific risk factors for long QT syndrome (eg, hypokalemia, bradycardia, and increased age). The majority of the available data is derived from case reports. A number of confounders complicate the determination of a causal link between QTc prolongation and citalopram. Of the 4 studies included for review, none identified significant QTc prolongation in patients taking citalopram 20 to 60 mg daily without the patients having one or more patient-specific risk factors for prolonged QTc.

Conclusion: There is insufficient evidence to establish a causal link between citalopram 20 to 60 mg orally daily and increased risk of TdP. Further research is required to determine the clinical impact and association between citalopram 20 to 60 mg daily and QTc prolongation.

Keywords: cardiac arrhythmia; citalopram; review; selective serotonin reuptake inhibitor; side effect.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Citalopram / administration & dosage*
  • Citalopram / adverse effects*
  • Humans
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / diagnosis*
  • Selective Serotonin Reuptake Inhibitors / administration & dosage*
  • Selective Serotonin Reuptake Inhibitors / adverse effects*

Substances

  • Serotonin Uptake Inhibitors
  • Citalopram