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DOI: 10.1055/s-2007-992147
© Georg Thieme Verlag KG Stuttgart · New York
Torsade de Pointes during Combined Treatment with Risperidone and Citalopram
Publication History
received 27.11.2006
revised 19.07.2007
accepted 23.07.2007
Publication Date:
21 November 2007 (online)
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Introduction
Drug-induced long QT syndrome may be associated with potentially life-threatening arrhythmias of the torsade de pointes (TDP) type. Several drugs have been demonstrated to be potentially associated with abnormal QT prolongation and TDP, particularly antiarrhythmic drugs such as quinidine, propafenone, and procainamide, some antimicrobial and antimalarial drugs like erythromycin, cotrimoxazole, chloroquine, several psychotropic agents, e.g., tricyclic antidepressants and antipsychotics [2] [3]. Factors that increase the risk for TDP include hypokalemia, hypomagnesemia, bradycardia, female gender, left ventricular hypertrophy, and heart failure. Furthermore, increased drug plasma concentrations resulting from drug interactions, renal or liver insufficiency leading to drug accumulation, overdosing and/or intoxication also significantly increase the risk [2]. We report the case of a woman with abnormal QT prolongation and TDP induced by a combination of risperidone and citalopram.
References
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- 2 Haverkamp W, Breithardt G, Camm AJ, Janse MJ, Rosen MR, Antzelevitch C, Escande D, Franz M, Malik M, Moss A, Shah R. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a policy conference of the European Society of Cardiology. Eur Heart J. 2000; 21 1216-1231
- 3 Haverkamp W, Deuschle M. Lengthening of QT interval by antipsychotic drugs. Nervenarzt. 2006; 77 276-288
- 4 Ostrom M, Eriksson A, Thorson J, Spigset O. Fatal overdose with citalopram. Lancet. 1996; 348 339-340
- 5 Personne M, Persson H, Sjoberg E. Citalopram toxicity. Lancet. 1997; 350 518-519
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Correspondence
Dr. med. D. Blaschke
Charité- Universitätsmedizin Berlin
Campus Virchow-Klinikum
Medizinische Klinik mit Schwerpunkt Kardiologie
Augustenburger Platz 1
13353 Berlin
Germany
Phone: +49/30/450 653 366
Fax: +49/30/450 553 957
Email: daniela.blaschke@charite.de