Reactions 614 - 17 Aug 1996

SCitalopram overdose

Death: 6 case reportsIntentional citalopram overdose was suspected to be the

cause of death in 2 men and 4 women aged 23–56 years.At autopsy, the patients had femoral vein blood citalopram

concentrations between 5.2 and 49 µg/g (therapeutic autopsyconcentration 0.3 µg/g), and high citalopram/desmethylcitalopram ratios indicating acute overdose.Concentrations of other drugs, where found, were low.

The probable ingested dose in 4 patients was 840–3920mg;the probable dose was unknown in the other 2 patients.

Author comment: One possible mechanism for death inthese patients is cardiac arrhythmias; no signs of seizures werefound. ‘Until further study of citalopram toxicity is done, werecommend the same precautions in prescription of citalopramas with tricyclic antidepressants to patients with a high risk ofsuicide.’Ostrom M, et al. Fatal overdose with citalopram. Lancet 348: 339-340, 3 Aug 1996- Sweden 800461820

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Reactions 17 Aug 1996 No. 6140114-9954/10/0614-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved