Why the study?
Citalopram and escitalopram are linked to QT prolongation and serious arrhythmia, prompting 2011 regulatory warnings. This study evaluated the risk of serious arrhythmia after initiating these drugs versus other SSRIs, before and after the warnings.
Does initiation of citalopram or escitalopram increase the risk of serious arrhythmia compared to other SSRIs in older adults?
Population
Patients aged ≥65 years in Denmark initiating an SSRI with a 1-year washout period
Comparison
Initiation of citalopram or escitalopram vs other SSRIs
Design
Nationwide target trial emulation cohort study
Follow-up
Maximum of 6 months
Authors
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May warrant caution with citalopram/escitalopram in high-risk patients; leaves open the real-world effect of 2011 warnings on arrhythmia outcomes.
Does initiation of citalopram or escitalopram increase the risk of serious arrhythmia compared to other SSRIs in older adults?
Initiation of citalopram or escitalopram in older adults was not associated with an increased risk of serious arrhythmia compared to other SSRIs, suggesting the absolute risk of clinically significant QT prolongation may be lower than regulatory warnings imply.
Aakjær et al. (2022) studied this question.
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