Key result
Citalopram intoxication links to ~542 ms QTc prolongation strongly correlating with serum drug levels.
Why the study?
Although citalopram is considered safe at therapeutic levels, the relationship between serum citalopram levels and QTc interval prolongation after intoxication is unclear.
Does the serum level of citalopram correlate with QTc interval prolongation after intoxication?
Case Report (n=1)
Does the serum level of citalopram correlate with QTc interval prolongation after intoxication?
Effect estimate: r=0.943
p-value: p=<0.005
Citalopram intoxication can lead to potentially hazardous QTc prolongation that correlates strongly with serum drug levels.
May inform QTc monitoring in citalopram overdose; hypothesis-generating given case-report design.
Citalopram (CIT) is a widely used antidepressant which acts by a selective serotonin reuptake inhibition. It is considered to be safer than tricyclic antidepressants at therapeutic levels, but also with respect to intoxications. We report the case of a 46-year-old woman, who ingested in suicidal intention 1400 mg CIT. During the following inpatient treatment repeatedly ECGs and determinations of the serum level of CIT were performed. Initially the patient's serum level of CIT was 1231 ng/mL and QTc interval was 541.60 ms. It took 12 days until the serum level of CIT fell below the upper threshold of the recommended therapeutic range (130 ng/mL). The QTc interval on the sixth day after the intoxication for the first time was below 500 ms. The QTc interval correlated significantly with the serum level of CIT after intoxication (r=0.943; p<0.005). Although CIT is estimated as a safe antidepressant regarding serious adverse effects, toxic doses can lead to potentially hazardous ECG changes which according to our findings correlate strongly with the serum level of the drug.
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Unterecker et al. (2011) conducted a case report in Citalopram intoxication (n=1). Citalopram was evaluated on Correlation between QTc interval and serum level of citalopram (r=0.943, p=<0.005). Citalopram intoxication (1400 mg) led to significant QTc prolongation (541.60 ms) that correlated strongly with serum citalopram levels (r=0.943; p<0.005).
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