Ventricular Arrhythmia Risk Compared for Four Antidepressants

The study lasted between 2002 to 2012 and included over 200,000 adults
The study lasted between 2002 to 2012 and included over 200,000 adults

Starting citalopram treatment in older adults was associated with an increase in the 90-day risk of hospital encounter for ventricular arrhythmias, when compared to two referent antidepressants. Findings from the study are published in PLOS One.

A team of Canadian researchers conducted a population-based retrospective cohort study of older adults (average age 76) from 2002–2012 who were newly prescribed citalopram (n=137,701) or escitalopram (n=38,436) vs. those prescribed referent antidepressants sertraline or paroxetine (n=96,620). The primary outcome measure was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription as determined by hospital diagnostic codes. Secondary outcome was all-cause mortality within 90 days. 

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The data showed an increased risk of a hospital encounter with ventricular arrhythmia with citalopram vs. referent antidepressants (0.06% s. 0.04%, relative risk [RR] 1.53, 95% CI: 1.03–2.29) as well as a higher risk of mortality (3.49% vs. 3.12, RR 1.12, 95% CI: 1.06–1.18). Escitalopram, however, was not associated with an increased risk of ventricular arrhythmia vs. referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI: 0.42–1.68) but an increased risk of mortality (2.86% vs. 2.63, RR 1.09, 95% CI: 1.1–1.18).

Findings from the study support a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia. 

For more information visit plos.org.

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