Suicide attempt by pure citalopram overdose causing long-lasting severe sinus bradycardia, hypotension and syncopes: Successful therapy with a temporary pacemaker

In few cases, pure citalopram overdose at doses above 600 mg showed electro -cardiographic changes with prolonged QT intervals and sinus bradycardia gr adually resolving within 12-24 hours after intoxication. We report on a 32- year-old patient with borderline personality disorder (BPD) who ingested a total of 800 mg citalopram to attempt suicide due to an interpersonal disap pointment. She developed severe sinus bradycardia with a minimal pulse rate of 41/min within about 4 hours after intoxication lasting up to six days d uring intensive care unit (ICU) treatment. Further, hypotension and syncope s occurred. No QT interval prolongations were recorded. To our knowledge, t his is the first case report of pure citalopram overdose-induced long-lasti ng sinus bradycardia associated with severe hypotension and intermittent sy ncopes that required therapy with a temporary pacemaker.