Reactions 1150 - 5 May 2007

★Citalopram

First report of Raynaud’s disease: case reportA 43-year-old woman developed Raynaud’s disease during

treatment with citalopram.The woman, who had no history of arthritis or Raynaud’s

disease, presented with general anxiety syndrome, depressivemood and insomnia. She started receiving citalopram25 mg/day, dipotassium clorazepate and zopiclone. Onpresentation, she had symmetric subcyanotic erythema on herhands; the subcyanotic episode had started 7 days after herpsychiatrist prescription. Laboratory values were normal andno evidence of endothelium-damaging disorders wasdetected, but further investigations revealed subcyanoticerythematous episodes associated with cold temperatures.Raynaud’s disease was diagnosed.

Since the woman’s anxiety disorder persisted, dipotassiumclorazepate and zopiclone were replaced by olanzapine andlormetazepam and her concomitant gabapentin was reduced;however, her clinical symptoms did not improve. Acitalopram-induced reaction was suspected and citalopramwas discontinued. Her symptoms of Raynaud’s diseaseimproved for over one month and no further recurrences ofRaynaud’s disease were reported.

Author comment: "Given that the symptoms startedshortly after citalopram therapy was initiated and wererelieved after it was discontinued, citalopram was thought tobe the cause."Peiro AM, et al. Citalopram-induced Raynaud’s phenomenon. RheumatologyInternational 27: 599-601, No. 6, Apr 2007 - Spain 801073532

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of Raynaud’s diseaseassociated with citalopram. The WHO Adverse Drug Reactionsdatabase contained 17 reports of peripheral ischaemiaassociated with citalopram.

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Reactions 5 May 2007 No. 11500114-9954/10/1150-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved