Dose-response association with QTc prolongation for citalopram, escitalopram, amitriptyline
WEDNESDAY, Jan. 30 (HealthDay News) -- Selective serotonin reuptake inhibitors, including citalopram, escitalopram, and amitriptyline, are associated with prolonged corrected QT (QTc) interval, according to a study published online Jan. 29 in BMJ.
Victor M. Castro, from Partners HealthCare System in Boston, and colleagues conducted a cross-sectional study using electrocardiographic, prescribing, and clinical data from electronic health records. The authors sought to examine the association between antidepressant dose and QTc in a cohort of 38,397 adult patients with an electrocardiogram recorded after prescription of antidepressants or methadone.
The researchers found that, for citalopram, escitalopram, and amitriptyline, but not for other antidepressants, there was a significant dose-response association with QTc prolongation. Bupropion was associated with a QTc shortening. The QTc prolonging effect of citalopram was supported by within-subject paired observations.
"Taken together, the present findings demonstrate the potential advantages of using electronic health records for post-marketing surveillance," the authors write. "While it cannot replace careful investigation of QT effects in phase II and III clinical trials, use of electronic health record data provides a useful complement, particularly in terms of comparison with other available interventions."
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.
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