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FDA alerts issued in 2011 and 2012 (http://www.fda.gov/Drugs/DrugSafety/ucm297391.htm) warned that patients receiving more than 40 mg/day of citalopram were at increased risk of dose-dependent QT interval prolongation. The alerts advised that citalopram not be prescribed at doses higher than 40 mg/day or, for patients over 60, higher than 20 mg/day, nor be used in patients with congenital long QT syndrome. Further, the alert noted that risk for the potentially fatal torsade de pointes was increased in patients with congestive heart failure and other specific cardiac-related problems.
Using data from a national Veterans Affairs (VA) depression registry and a national mortality index, investigators with VA funding examined records from 2004–20…