Reactions 1351 - 14 May 2011

SCitalopram

Long QT syndrome and torsade de pointes: casereport

A 48-year-old woman developed long QT syndrome andtorsade de pointes while receiving citalopram.

The woman, who had a history of depression, had beenreceiving citalopram 40 mg/day for at least 5 years [routenot stated]. She was also receiving furosemide for systolichypertension. She was referred for syncope of recent-onset[duration of therapy to reaction onset not clearly stated].She also reported a 5-day history of diarrhoea associatedwith a flu-like syndrome. On admission, her BP was130/70mm Hg and ECG revealed widespread ST-T segmentdepression with prolonged QT and QTc intervals.

Citalopram was immediately withdrawn. Laboratoryanalysis revealed low levels of potassium and chloride. ECGmonitoring during hospitalisation revealed nonsustainedventricular tachycardia on several occasions. The womanalso experienced torsade de pointes three times within thefirst 24 hours of admission, with electrical shock therapyrequired for two of these episodes to restore sinus rhythm.To prevent further arrhythmia, temporary right ventricularpacing was programmed faster than spontaneous rhythm.She received magnesium sulfate and potassium-glucose-insulin solution. On the fifth day of admission, her QTinterval on ECG, as well as her potassium and chloridelevels, had normalised. Her follow-up was uneventful.De Gregorio C, et al. Citalopram-induced long QT syndrome and torsade depointes: Role for concomitant therapy and disease. International Journal ofCardiology 148: 226-228, No. 2, 14 Apr 2011. Available from: URL: http://dx.doi.org/10.1016/j.ijcard.2009.05.060 - Italy 803054023

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Reactions 14 May 2011 No. 13510114-9954/10/1351-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved