The Medical Letter on Drugs and Therapeutics
Citalopram, Escitalopram and the QT Interval
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In 2011, the FDA asked the manufacturers of the selective serotonin reuptake inhibitor (SSRI) citalopram (Celexa, and generics) to lower the maximum daily dosage of the drug because of a dose-related increase in the QT interval.1 Since then, some of our readers have asked whether escitalopram (Lexapro, and generics), the active enantiomer of citalopram, could have the same effect.

THE QT INTERVAL — The upper limit of normal for the QT interval is about 400 milliseconds (ms) for a heart rate of 80 and 440 ms for a heart rate of 60. Prolongation of the QT interval beyond 500 ms increases the risk of torsade de pointes, a rare but potentially fatal ventricular arrhythmia. Other risk factors for torsade de pointes include hypokalemia, hypomagnesemia, bradycardia and heart failure.2

CITALOPRAM AND ... more      

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