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. 

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