Pharmacopsychiatry 2010; 43(7): 279-281
DOI: 10.1055/s-0030-1263167

© Georg Thieme Verlag KG Stuttgart · New York

Torsade de Pointes Episodes under Treatment with Selective Serotonin Reuptake Inhibitors

K. Wenzel-Seifert1 , M. Wittmann2 , E. Haen2
  • 1Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
  • 2Clinical Pharmacology, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
Further Information

Publication History

received 26.04.2010 revised 05.07.2010

accepted 23.07.2010

Publication Date:
06 October 2010 (online)

Selective serotonin-reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants and are generally well tolerated. Specifically, less cardiovascular toxicity has been reported in comparison with tricyclic antidepressants. However, an increasing number of case reports and reviews of pharmacovigilance and toxicology databases describes an association of life-threatening cardiac arrhythmias known as torsade de pointes (TdP) with the use of citalopram and fluoxetine in therapeutic and toxic doses. In therapeutic doses, SSRI-associated Tdp concerned patients with additional risk factors such as concomitant cardiovascular disease, age over 65 years, female sex, hypokalemia and hypomagnesemia. Prolongation of the QTc interval predisposing to the occurrence of TdP has been observed with all SSRIs in supratherapeutic concentrations.


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K. Wenzel-SeifertMD 

Institute of Pharmacology

Medical School of Hannover

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