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. 2015 Oct;80(4):698-705.
doi: 10.1111/bcp.12681. Epub 2015 Jul 29.

Use of selective serotonin re-uptake inhibitors and the heart rate corrected QT interval in a real-life setting: the population-based Rotterdam Study

Nevena M Maljuric  1 , Raymond Noordam  1   2 , Nikkie Aarts  1   2 , Maartje N Niemeijer  1 , Marten E van den Berg  3 , Albert Hofman  1 , Jan A Kors  3 , Bruno H Stricker  1   2   4 , Loes E Visser  1   2   5
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Use of selective serotonin re-uptake inhibitors and the heart rate corrected QT interval in a real-life setting: the population-based Rotterdam Study

Nevena M Maljuric et al. Br J Clin Pharmacol. 2015 Oct.

Abstract

Aims: Selective serotonin re-uptake inhibitors (SSRIs), specifically citalopram and escitalopram, are thought to cause QTc prolongation, although studies have shown contradictory results. Nevertheless, a maximum citalopram dosage of 20 mg in high risk patients (e.g. >60 years of age) is recommended. We aimed to investigate the association between use of (individual) SSRIs and QTc in a population-based study in older adults.

Methods: This study, which was part of the prospective Rotterdam Study (period 1991-2012), included participants with up to five electrocardiograms (ECGs). We used linear mixed models to compare QTc F (QT corrected according to Fridericia) measured during use of individual SSRIs with QTc F measured during non-use of any antidepressant. For citalopram, analyses were additionally restricted to a maximum dosage of 20 mg in participants aged 60 years and older.

Results: We included 12 589 participants with a total of 26 620 ECGs of which 436 ECGs were made during SSRI use. The mean QTc F was similar during use of any drugs from the SSRI class and during non-use. After stratifying to individual SSRIs, ECGs recorded during use of citalopram had the longest QTc compared with ECGs recorded during non-use (+12.8 ms, 90% CI 7.5, 18.2). This result remained similar in the analysis comprising participants aged 60 years and older with a maximum prescribed daily dosage of 20 mg citalopram.

Conclusions: Although no SSRI class effect was observed, use of citalopram was associated with a longer QTc F, even after considering the recommended restrictions. Other SSRIs may not give a clinically relevant QTc F prolongation.

Keywords: electrocardiography; population surveillance; serotonin re-uptake inhibitors.

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References

    1. Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death: epidemiology, transient risk, and intervention assessment. Ann Intern Med. 1993;119:1187–97. - PubMed
    1. Myerburg RJ, Interian A, Jr, Mitrani RM, Kessler KM, Castellanos A. Frequency of sudden cardiac death and profiles of risk. Am J Cardiol. 1997;80:10F–19F. - PubMed
    1. Gorgels AP, Gijsbers C, de Vreede-Swagemakers J, Lousberg A, Wellens HJ. Out-of-hospital cardiac arrest - the relevance of heart failure. The Maastricht Circulatory Arrest Registry. Eur Heart J. 2003;24:1204–9. - PubMed
    1. Zipes DP, Wellens HJ. Sudden cardiac death. Circulation. 1998;98:2334–51. - PubMed
    1. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350:1013–22. - PubMed

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