Patients who take high doses of two antidepressants - citalopram (Celexa) and escitalopram (Lexapro) - may be at risk of developing the prolongation of the QT interval, according to a study published online January 29, 2013 in the British Medical Journal.
Prolongation of the QT interval is significant because it is a marker of increased risk of sudden death and ventricular arrhythmia (abnormal heart rhythm)
When Dr. Roy h. Perlis of Massachusetts General Hospital and his team examined the records of 38,000 people, they found what they described as a "small but significant" association between the prolongation of the QT interval and the requirements for these two drugs. However, some other anti-depressants – fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), duloxetine (Cymbalta), mirtazapine (Remeron), nortriptyline (Pamelor) and venlafaxine (Effexor) - do not exhibit this effect. and Bupropion (Wellbutrin) was associated with a shortening of the QT interval.
The effect increased with higher doses, suggesting a dose-response, according to Perlis association.
Perlis concludes, however, that, for the most part, these antidepressants benefits still outweigh risks, especially if you have not the risk factors for cardiac arrhythmias and take a lower dose.
"The message to prevail," said Perlis, "is that most of the newer antidepressants are very safe from a point of view of heart rate. I worry about people stopping their antidepressants unnecessarily at risk of QT interval'.
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