Antidepressant Celexa may up risk of irregular heartbeat

Washington, January 30 (ANI): In 2011 the U.S. Food and Drug Administration issued a warning against the use of popular antidepressant citalopram (Celexa), but it left many patients and physicians with more questions than answers.

Now an analysis of the medical records of more than 38,000 patients by Massachusetts General Hospital (MGH) investigators clarifies the contribution of citalopram and other antidepressants to lengthening of the QT interval, an aspect of the heart's electrical activity that - when prolonged - may increase the risk of dangerous arrhythmias.

The study supported the FDA's warning that higher doses of citalopram were associated with a prolonged QT interval but also found that the effects of some other antidepressants were quite different.

"It was important to confirm the effects of citalopram - one of the most widely prescribed antidepressants in the U.S. - because the FDA warning really gave us minimal clinical guidance," said Roy Perlis, MD, of the MGH Department of Psychiatry.

Many medications - including some older antidepressants - are known to increase the QT interval, which is the time from the beginning of electrical activation of the heart to the end of electrical relaxation. While the vast majority of individuals with QT prolongation have no heart rhythm abnormalities, it is a recognized risk factor for a rare but dangerous arrhythmia called torsades de pointes.

The MGH team examined the health records of 38,397 patients who had an EKG reading taken at a Partners facility between 14 and 90 days after receiving a prescription for one of 11 different antidepressant drugs or for methadone, which is known to prolong QT interval.

Their analysis confirmed the association of a slight but significant QT prolongation with higher doses of citalopram, along with the known associations with methadone and with the older antidepressant amitriptyline. The results also associated QT prolongation with the newer antidepressant escitalopram (Lexapro); but many other drugs - including fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) - had no effect on QT interval. The antidepressant bupropion (Wellbutrin/Zyban) was actually associated with shortening the QT interval.

Perlis cautions that the results of this study should not cause patients taking citalopram or escitalopram to stop taking their medication.

"I worry more about people stopping their antidepressants unnecessarily than about the QT prolongation risks. For patients starting a new antidepressant who have other risk factors for arrhythmias, a drug other than citalopram would probably be a wise choice. But for those already taking lower doses of either of these drugs, the QT prolongation effects seem to be modest. The real message to patients taking these drugs is to have a conversation with their doctors," he said.

Their finding will appear in the journal BMJ and is being released online. (ANI)

Matches

MORE TOP STORIES TODAY

Pietersen may play against Hyderabad

Pietersen may play against Hyderabad

As much as Pietersen's availability is a boost, the loss of a potent death bowler might sting Delhi badly. More »

Struggling Mumbai need batting fuel

Struggling Mumbai need batting fuel

Mumbai have explosive hitters down the order in the form of Corey Anderson and Kieron Pollard, but the lack of contributions from them has compounded their… More »

Boycotting IPL will not save cricket

Boycotting IPL will not save cricket

Boycotting the IPL as a means of protest against the grime in the game may not yield the desired results. More »

Srinivasan's ICC presence to be challenged

Srinivasan's ICC presence to be challenged

Srinivasan, who has been replaced by the court as board president, was named the BCCI's representative to the ICC last September. However, that position… More »

Brilliant Maxwell powers Punjab’s renaissance

Brilliant Maxwell powers Punjab’s renaissance

Maxwell has easily been the best player on display in the first nine days, with scores of 95, 89 and 95 helping Punjab shed their image of also-rans and… More »

Indian cricket is now dope-free

Indian cricket is now dope-free

The BCCI conducted over 200 dope tests during senior domestic tournaments in the just-ended 2013-14 season – the largest number of tests done by an ICC… More »

Bangalore lose nerve, lose game

Bangalore lose nerve, lose game

IPL 7, GAME 11—Vinay's over, Lynn's catch turns last-over finish in KKR's favour. More »

Couldn't turn down ECB offer: Farbrace

Couldn't turn down ECB offer: Farbrace

England's new assistant coach Paul Farbrace admitted that it was impossible turn down the job even though he will have mixed feelings when he faces… More »

Atapattu likely to be SL interim coach

Atapattu likely to be SL interim coach

Sri Lanka's chief selector Sanath Jayasuriya issued the strongest indication yet that Marvan Atapattu would be appointed coach for the tour of Ireland… More »

T20 is all about the little things: Balaji

T20 is all about the little things: Balaji

Balaji acknowledged Maxwell’s role in Punjab’s great start to season seven, but he insists that the efforts of other players like Virender Sehwag, among… More »

Cleaning up the game starts with fans

Cleaning up the game starts with fans

... because, as recent events reveal, the BCCI has little intention of doing it. More »

Jadeja spins out Rajasthan in close chase

Jadeja spins out Rajasthan in close chase

IPL 7, GAME 10—Chennai beat Rajasthan by 7 runs after last-over scare. More »

Is Srini group delaying BCCI meeting?

Is Srini group delaying BCCI meeting?

The group opposed to Srinivasan alleged that since BCCI secretary Sanjay Patel belongs to the president’s group, he was intentionally delaying the SGM… More »

'BCCI should have picked panel with care'

'BCCI should have picked panel with care'

Dalmiya said that it was the first time that the BCCI had been faced with a situation where the apex court had hauled up the Board and it should have acted… More »

Vithanage, Priyanjan get T20 call-ups

Vithanage, Priyanjan get T20 call-ups

Herath has been rested, while the team will be without the veteran pair of Mahela Jayawardene and Kumar Sangakkara, who retired from T20 internationals… More »

'Gambhir will strike form soon'

'Gambhir will strike form soon'

Gautam made an eight-ball duck in the opening game against Mumbai and in the second game against Delhi, he lasted only half those balls. More »

SL in 'difficult place' after Farbrace exit

SL in 'difficult place' after Farbrace exit

Sri Lanka depart for assignments in Ireland and England in two weeks, and Sanath Jayasuriya suggested Marvan Atapattu would be interim head coach for those… More »

Chandimal axed as T20 captain

Chandimal axed as T20 captain

Sri Lanka's cricket selectors on Wednesday sacked Dinesh Chandimal as Twenty20 captain and replaced him with Lasith Malinga, while Angelo Mathews was… More »

Farbrace is England's assistant coach

Farbrace is England's assistant coach

The ECB continued the restructuring of the England coaching set-up on Wednesday by announcing the appointment of Paul Farbrace as assistant coach. More »

SC asks Mudgal committee to continue

SC asks Mudgal committee to continue

Mukul Mudgal has communicated to the court his willingness to take up the investigation and has been asked to specify the terms and modalities on April… More »

Sri Lanka players resolve pay dispute

Sri Lanka players resolve pay dispute

The pay dispute between Sri Lanka Cricket and its 13 contracted players ended on Wednesday when the latter agreed to accept 10 percent of the participation… More »

Hope to be fit for next game - Pietersen

Hope to be fit for next game - Pietersen

With two heavy defeats at the hands of Bangalore and Chennai, Daredevils currently languish near the bottom of the table. More »

'SC decision could hurt BCCI's status'

'SC decision could hurt BCCI's status'

The Supreme Court prefers that the Justice Mudgal panel further investigate the IPL corruption scandal. More »

Mudgal panel drops bombshell in court

Mudgal panel drops bombshell in court

The Mukul Mudgal probe committee dropped a bombshell in the Supreme Court on Tuesday by making a sensational claim that it was forced to stop audio recording… More »