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西酞普兰引起的QTc间期延长和尖端扭转型室性心动过速。

Prolonged QTc interval and torsades de pointes induced by citalopram.

作者信息

Deshmukh Anand, Ulveling Kyle, Alla Venkata, Abuissa Hussam, Airey Kelly

机构信息

Department of Cardiovascular Medicine, The Cardiac Center of Creighton University, Omaha, Nebraska 68131, USA.

出版信息

Tex Heart Inst J. 2012;39(1):68-70.

Abstract

Citalopram is a selective serotonin reuptake inhibitor with a favorable cardiac-safety profile. Corrected QT interval (QTc) prolongation and cardiac arrhythmias have not been previously reported in association with citalopram use except in the presence of overdose, abnormal electrolyte values, or renal or liver failure. Herein, we report the case of a 40-year-old woman with mental depression who presented with a prolonged QTc interval and torsades de pointes after the initiation of citalopram at therapeutic doses. The QTc interval improved when citalopram therapy was discontinued. We recommend that clinicians investigate the family history for sudden deaths and perform baseline electrocardiography before prescribing citalopram. We also recommend routine electrocardiographic testing during citalopram therapy, and that patients with long QT syndrome avoid taking citalopram.

摘要

西酞普兰是一种选择性5-羟色胺再摄取抑制剂,具有良好的心脏安全性。除了过量用药、电解质值异常或存在肾或肝功能衰竭的情况外,此前尚未有与使用西酞普兰相关的校正QT间期(QTc)延长和心律失常的报道。在此,我们报告一例40岁患有精神抑郁症的女性病例,该患者在开始使用治疗剂量的西酞普兰后出现QTc间期延长和尖端扭转型室性心动过速。停用西酞普兰治疗后,QTc间期有所改善。我们建议临床医生在开具西酞普兰处方前调查患者家族猝死史并进行基线心电图检查。我们还建议在西酞普兰治疗期间进行常规心电图检测,并且长QT综合征患者应避免服用西酞普兰。

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本文引用的文献

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Torsade de pointes induced by citalopram and amiodarone.西酞普兰与胺碘酮诱发的尖端扭转型室性心动过速。
Ann Cardiol Angeiol (Paris). 2011 Jun;60(3):165-8. doi: 10.1016/j.ancard.2010.12.002. Epub 2011 Jan 20.
8
Citalopram toxicity.西酞普兰中毒
Lancet. 1997 Aug 16;350(9076):518-9. doi: 10.1016/s0140-6736(05)63109-1.
9
Symptoms and signs of severe citalopram overdose.西酞普兰严重过量的症状和体征。
Lancet. 1997 May 31;349(9065):1602. doi: 10.1016/S0140-6736(05)61630-3.
10
Fatal overdose with citalopram.西酞普兰致死性过量服用。
Lancet. 1996 Aug 3;348(9023):339-40. doi: 10.1016/s0140-6736(05)64513-8.

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