Reactions 1336 - 29 Jan 2011

SCitalopram

Bradycardia in an elderly patient: case reportA 66-year-old man with panic disorder developed

bradycardia during treatment with higher doses ofcitalopram [route not stated].

Two months after starting treatment with citalopram10 mg/day, the man reported an improvement in hisanxiety and panic attacks. His dosage was increased to20 mg/day and 2 days later, he reported feeling dizzy andlightheaded. Over the following 48 hours, his mean HR was47 beats/min. He reported the sensation of somethingmoving inside his body.

The man’s citalopram dosage was reduced to 10 mg/daywith resolution of his lightheadedness within 1 day. Overthe subsequent 48 hours, his mean HR was 71 beats/min.His heart rate remained stable, but he began having panicattacks 3–4 times a week. After a month, his citalopramdosage was increased to 20 mg/day with a prompt return ofhis bradycardia. His dosage was reduced, and he remainedin good control of his panic disorder at a dosage of10 mg/day.

Author comment: "We assessed the development ofbradycardia with citalopram . . . The Naranjo et al probabilityscale revealed a highly probable adverse reaction."Padala KP, et al. Dose-dependent bradycardia with citalopram in an elderly patient.Primary Care Companion to the Journal of Clinical Psychiatry 12: 1-2, No. 1,2010. Available from: URL: http://dx.doi.org/10.4088/pcc.09l00789blu -USA 803048649

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Reactions 29 Jan 2011 No. 13360114-9954/10/1336-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved