Citalopram treatment resulted in a small reduction in heart rate (≤8 beats per minute) but had no significant effects on PQ, QRS, or QTc intervals.
Does citalopram affect cardiac conduction and repolarization in healthy volunteers and patients with depression or dementia?
Citalopram appears to have a benign cardiovascular safety profile with no significant adverse effects on cardiac conduction or repolarization.
The selective serotonin reuptake inhibitors (SSRIs) are believed to have a more benign cardiovascular safety profile than do the tricyclic antidepressants. The effects of the SSRI citalopram on cardiac conduction and repolarization have been extensively evaluated, both in prospective studies in volunteers and patients and in retrospective evaluations of all electrocardiographic (ECG) data from all clinical trials conducted from 1978 through 1996 (a total of 40 studies). A randomized, double-blind, placebo-controlled study was conducted in healthy volunteers (N = 23) to assess intraindividual variability of the QTc interval, as well as possible changes during treatment with placebo or citalopram, and its correlation to plasma drug levels. To document any dose-related changes, ECGs were performed at baseline and at the end of study in three randomized, double-blind, placebo- or active-controlled, fixed-dose trials in adult and elderly patients (N = 1,460) with major depression and/or dementia. Finally, more than 6,000 ECGs (N = 1,789 citalopram-treated patients) collected from all clinical trials conducted from 1978 through 1996 were reassessed in a standardized manner to identify any effects of citalopram on ECG parameters. Results of both prospective and retrospective analyses showed that the only effect of citalopram on ECG findings is a small reduction in heart rate (< or = 8 beats per minute). There were no significant effects on PQ, QRS, or QTc intervals, indicating that citalopram has no effect on cardiac conduction and repolarization during short- or long-term treatment.
Rasmussen et al. (Fri,) conducted a review in Major depression and/or dementia (n=3,272). Citalopram vs. Placebo or active control was evaluated on ECG parameters (PQ, QRS, QTc intervals and heart rate). Citalopram treatment resulted in a small reduction in heart rate (≤8 beats per minute) but had no significant effects on PQ, QRS, or QTc intervals.