Alušík Štefan, Paluch Zoltán
Vnitr Lek. 2018 Winter;63(12):952-956.
In 2011/2012, the US Food and Drug Administration issued a warning about the effect of citalopram on the QT interval and decreased its dosing. Further studies addressing this issue have been published since then. The authors were interested to know whether or not the studies have furnished new information that could modify or further specify the FDA-issued recommendations. After analyzing the most relevant studies, the authors concluded that even papers published within the last 5 years confirmed that, of the SSRI class of drugs, citalopram prolongs the QT interval most significantly. While the QT interval prolongation in young and otherwise healthy individuals is small and treatment with citalopram relatively safe, in elderly comorbid patients with polypharmacy, use of even currently recommended doses may result in significant QT interval prolongation. Hence, the decision about future therapy will depend on the degree of risk of each individual patient. Judging by the most recent data, citalopram is not more effective compared with the other SSRIs. As a result, therapy with citalopram will presumably show a declining trend, particularly in elderly patients.Key words: citalopram - escitalopram - QT interval - SSRI.
2011/2012年,美国食品药品监督管理局就西酞普兰对QT间期的影响发布了一项警告,并降低了其用药剂量。自那时起,针对该问题的进一步研究相继发表。作者们想要了解这些研究是否提供了新的信息,从而能够修改或进一步明确美国食品药品监督管理局发布的建议。在分析了最相关的研究后,作者们得出结论,即使是过去5年内发表的论文也证实,在选择性5-羟色胺再摄取抑制剂(SSRI)类药物中,西酞普兰对QT间期的延长最为显著。虽然年轻及其他方面健康的个体中QT间期延长幅度较小,使用西酞普兰治疗相对安全,但在患有多种疾病且同时服用多种药物的老年患者中,即使使用目前推荐的剂量也可能导致QT间期显著延长。因此,关于未来治疗的决策将取决于每个患者的风险程度。根据最新数据判断,与其他SSRI相比,西酞普兰并无更高的疗效。因此,西酞普兰的治疗可能会呈下降趋势,尤其是在老年患者中。关键词:西酞普兰 - 艾司西酞普兰 - QT间期 - SSRI