Reactions 1394 - 24 Mar 2012

O SCitalopram overdose

Atrial arrhythmia: case reportA 20-year-old man developed atrial arrhythmia after

taking citalopram [route not stated] in a suicide attempt.The man was transported to an emergency room after

taking 20 (400mg) citalopram in a suicide attempt due to apsychosocial stress factor 3 hours earlier [time to reactiononset not clearly stated]. He had informed his relatives afew minutes after the suicide attempt. His regularmedications included citalopram 20 mg/day for anxietydisorder. On examination, his BP was 110/70mm Hg, andanxiety, regret, agitation, irritability, anhedonia, depressivemode, and insomnia findings were apparent. Repeat ECGsrevealed a negative P-wave on derivations DII, DIII, aVF, V5and V6, and a positive P-wave on derivation aVR; hisrhythm was atrial, originating from the left atrium. He washospitalised for follow-up.

An ECG performed at the 62nd hour of follow-up wasnormal, with electric activity originating from the sinusnode. Psychiatric evaluation was requested on hospitalday 4; sertraline and alprazolam were initiated for a pre-diagnosis of mixed anxiety depressive disorder. At lastobservation, the man had not experienced any cardiacproblems.

Author comment: Atrial rhythm was activated because thehigh dose of citalopram depressed the sinus node.Korkmaz S, et al. A case of a suicide attempt with sitalopram causing supressionof sinusal rhythm with development of atrial rhythm. Dusunen Adam 24: 349-351,No. 4, Dec 2011. Available from: URL: http://dx.doi.org/10.5350/dajpn2011240412 [Turkish; summarised from a translation] - Turkey 803068327

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Reactions 24 Mar 2012 No. 13940114-9954/10/1394-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved