QTc interval prolongation associated with citalopram overdose: A case report and literature review

Citalopram is a member of the selective serotonin reuptake inhibitor class of antidepressants. In 1998, citalopram was approved by the US Food and Dru g Administration for the treatment of major depression. Like the other sele ctive serotonin reuptake inhibitors, citalopram enjoys a relatively benign side effect profile compared with the tricyclic antidepressants and the mon oamine oxidase inhibitors. However, citalopram has been associated with ele ctrocardiographic changes and seizures at doses greater than 600 mg per day . Fatalities have occurred with citalopram-only overdoses. We report the ca se of a healthy 21-year-old woman who developed QTc interval prolongation a fter ingestion of approximately 400 mg citalopram. We discuss the cardiac e ffects of citalopram, review previous cases of citalopram overdose, and dis cuss treatment recommendations.