Reactions 999 - 1 May 2004

★Citalopram

First report of hypertension in an elderly patient:case report

An 87-year-old woman developed hypertension afterreceiving her first dose of citalopram for a major depressiveepisode.

The woman, who had a history of congestive heart failure,diabetes mellitus, essential hypertension, migraine andhypothyroidism, presented with a headache following anepisode of presyncope that had developed 3 hours after takingher first dose of citalopram 20mg. Prior to starting citalopramtreatment her BP was 145/70mm Hg, with a HR of86 beats/min, and an ECG had revealed first-degreeatrioventricular block, nonspecific inferior T-wave abnormalityand minimal ST elevation. On presentation she had a BP of200/100mm Hg and a HR of 90 beats/min, and an ECG did notreveal any significant changes.

Citalopram was discontinued and, within 24 hours, thewoman’s BP decreased to 150/80mm Hg and remained stablefor 8 days; her HR varied between 72 and 96 beats/min duringthis time.

Author comment: "According to the Naranjo probabilityscale, this acute episode of hypertension was probablyassociated with citalopram."Sagduyu A, et al. Hypertension associated with citalopram. Journal of PharmacyTechnology 20: 14-16, No. 1, Jan-Feb 2004 - Turkey 800972916

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of hypertension associatedwith citalopram. The WHO Adverse Drug Reactions databasecontained 108 reports of hypertension associated withcitalopram.

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Reactions 1 May 2004 No. 9990114-9954/10/0999-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved