Reactions 1269 - 12 Sep 2009

★ SCitalopram

Herpes zoster (first report) in an elderly patient:2 case reports

A 73-year-old woman started receiving citalopram 20mg[frequency not stated] for mild depression and presentedwith a typical form of cervical herpes zoster 6 weeks later. Asecond woman, aged 49 years old, had mild depressionwith many somatic symptoms and started receivingcitalopram 20mg [frequency not stated] and clovazame[sic]. Four weeks later, she presented with herpes zosterinvolving pain and a rash at the thoracic dermatome. Inboth cases, a dermatologist confirmed a diagnosis ofherpes zoster. Both women received aciclovir, withoutcessation of their previous therapy. Neither womandeveloped post-herpetic neuralgia. [Outcomes not clearlystated.]

Author comment: In a study on the effects of repeatedfluoxetine and citalopram administration on the immunesystem of mice, it was shown that the immunomodulatoryeffects of SSRIs depend on the specific SSRI used and theduration of administration. If such specific and time-relatedeffects on immunity exist in humans, it is possible that theycould have acted as triggers for the [varicella zoster virus]reactivation in these cases of herpes zoster.Spyropoulou AC. Two cases of herpes zoster, occurring 4 and 6 weeks after theinitiation of citalopram treatment. Psychiatry Research 168: 265, No. 3, 15 Aug2009 - Greece 801150412

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of herpeszoster associated with citalopram. The WHO ADR databasecontained three reports of herpes zoster associated withcitalopram.

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Reactions 12 Sep 2009 No. 12690114-9954/10/1269-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved