Increasing Doses of Citalopram, Escitalopram, and Amitriptyline are Associated with QT Interval Prolongation

In 2011, the FDA warned that citalopram, a selective serotonin reuptake inhibitor (SSRI), causes dose-dependent corrected QT interval (QTc) prolongation, which is associated with risk for torsade de pointes. Whether other antidepressants also cause such prolongation is unclear. In this study, investigators used electrocardiogram (ECG), prescription, and clinical data from a New England healthcare system to determine the effects of antidepressant use on QTc.

Overall, 20% of >38,000 adults who underwent ECGs after receiving prescriptions for antidepressants exhibited abnormal QTc. Adjusted for multiple factors, citalopram, escitalopram (Lexapro), and amitriptyline were associated significantly with dose-dependent QTc prolongation. In contrast,…