Antidepressant Effects on the QTc Interval: Clinical Implications

Some antidepressants can prolong the heart rate–corrected QT (QTc) interval, but the clinical importance for individual patients is unclear. To compare QTc prolongation among different antidepressants, researchers examined individual-participant data from 35 randomized, placebo-controlled trials of 10 antidepressants: amitriptyline, bupropion, duloxetine, escitalopram, fluoxetine, mirtazapine, paroxetine, trazodone, venlafaxine, and vortioxetine. Researchers assessed QTc changes within 8 weeks in 8700 adults with major depressive disorder, accounting for baseline QTc, age, sex, body-mass index, potassium levels, and estimated glomerular filtration rate.