Meta-Analysis of Selective Serotonin Reuptake Inhibitor–Associated QTc Prolongation

Abstract

SSRIs were associated with a modest but statistically significant increase in the QTc interval, although to a lesser extent than TCAs; this finding was not limited to any single study. Citalopram was associated with more QTc prolongation than most other SSRIs.

Anksioznost in koronarna bolezen srca

“…Podaljšanje intervala lahko povzroči prekatno aritmijo in nenadno srčno smrt (57). V večji presečni študiji sta bila samo citalopram in escitalopram povezana s podaljšanjem intervala QTc (58), medtem ko je metaanaliza randomiziranih kliničnih raziskav pokazala, da na podaljšanje dobe QTc vplivajo tudi sertralin, paroksetin in fluvoksamin, a manj kot citalopram in escitalopram (59). Citalopram v odmerku 20 mg ali manj je pri starejših od 60 let povečal interval QTc za 20ms (57).…”

Guidelines of the Polish Psychiatric Association – Wroclaw Division, the Polish Society of Family Medicine and the College of Family Physicians in Poland for diagnosis and treatment of depressive disorders in primary health care

“…due to the risk of the significant dose-dependent prolongation of the Qtc interval during pharmacotherapy with ssris (especially with citalopram and escitalopram) or tricyclic antidepressants (tCas), it is advisable to perform, prior to such treatment, an electrocardiographic examination, especially in patients at risk of Qtc interval prolongation and those receiving several medicines that affect the potassium channels in the electrical conduction system [40].…”

Criticisms of drugs in early development for the treatment of depression: what can be improved?

“…Other crucial problems with conventional antidepressants include the lag of 2 --4 weeks between antidepressant administration and onset of clinical improvement, as well as safety and tolerability issues such as significant weight gain that can result in metabolic syndrome, increasing the risk of cardiovascular diseases. Moreover, recent studies suggest that conventional antidepressants, selective serotonin reuptake inhibitors (SSRIs), are also associated with a significant increase in the QTc interval [2]. Serotonin syndrome is another critical toxicity of serotonergic drugs [3].…”