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February 12, 2023February 17, 2023

Do all SSRIs cause QT prolongation?

Do all SSRIs cause QT prolongation?

Case reports of QT prolongation have been published with all of the SSRIs, with the exception of paroxetine, but many of these events were in the context of an overdose, inherent risk factors, and concomitant use of other medications known to increase the QT interval, which makes it difficult to draw conclusions. BE

Which SSRIs cause QT prolongation?

Selective Serotonin Reuptake Inhibitors (SSRIs): There are published case reports linking all six currently available SSRIs (fluvoxamine, fluoxetine, paroxetine, sertraline, citalopram, and escitalopram) to QTc prolongation. BE

Do SSRIs increase QTc?

Iribarren and colleagues studied patients taking a number of SSRIs. The following mean increases in QTc were fluoxetine, 13.0 ms (12.4–13.6), paroxetine, 12.4 ms (11.6–13.2), sertraline, 11.6 ms (10.3–12.9), and citalopram, 10.4 ms (9.2–11.6). BE

Which medication is contraindicated in patients with congenital long QT syndrome?

Table 1

Drugs to be avoided in patients with c-long QT syndrome
α1-blocker Alfuzosin
Bronchodilator/decongestant Albuterol, Salmeterol, Metaproterenol, Terbutaline, Metaproterenol, Levalbuterol, Ephedrine, Phenylpropanolamine, Pseudoephedrine
Cholinesterase inhibitor Galantamine
CNS stimulant Amphetamine

Does Zoloft prolong QT interval?

05), even at higher doses. Other standard antidepressants, including fluoxetine (Prozac, Eli Lilly), paroxetine (Paxil, GlaxoSmithKline) and sertraline (Zoloft, Pfizer) had no effect on QT interval, and further analyses did not significantly alter the results, according to a press release. BE

Which SSRI is the safest?

Citalopram and escitalopram have been considered the safest among the SSRIs with respect to potential for liver injury [41]. BE

Does Zoloft increase QT interval?

Other standard antidepressants, including fluoxetine (Prozac, Eli Lilly), paroxetine (Paxil, GlaxoSmithKline) and sertraline (Zoloft, Pfizer) had no effect on QT interval, and further analyses did not significantly alter the results, according to a press release. BE

Can sertraline cause QT prolongation?

The overall magnitude of QT prolongation with SSRIs is small. Sertraline may be the best first-line antidepressant for patients at risk for QT prolongation. Higher doses of citalopram may be appropriate in some patients with careful selection and judicious monitoring. BE

Does Zoloft increase QTc?

Fluoxetine, fluvoxamine, and sertraline at traditional doses demonstrate a lack of clinically significant increases in QTc in the majority of studies. Further, paroxetine monotherapy shows a lack of clinically significant QTc prolongation in all studies. BE

Does Zoloft prolong the QT interval?

05), even at higher doses. Other standard antidepressants, including fluoxetine (Prozac, Eli Lilly), paroxetine (Paxil, GlaxoSmithKline) and sertraline (Zoloft, Pfizer) had no effect on QT interval, and further analyses did not significantly alter the results, according to a press release. BE

Is there QT prolongation with tricyclic antidepressants?

  • QT prolongation appears to be a class effect for all selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), and also occurs with venlafaxine. The potential for QT prolongation to occur should be considered as part of the risk benefit assessment prior to prescribing an antidepressant.

Which is the lowest risk for QT prolongation?

  • Based on current literature, fluoxetine, fluvoxamine, and sertraline appear to have similar, low risk for QT prolongation, and paroxetine appears to have the lowest risk. However, there are significant limitations in interpreting the studies, including varying definitions of significant QT prolongation.

When to stop citalopram for QT prolongation?

  • There are no high quality data comparing the risk of QT prolongation between different antidepressants (other than citalopram and escitalopram). If QT prolongation or symptomatic arrhythmia occurs during antidepressant treatment, the antidepressant should be stopped or the dose reduced and specialist advice sought.

Is there QT prolongation with paroxetine monotherapy?

  • Further, paroxetine monotherapy shows a lack of clinically significant QTc prolongation in all studies. However, case reports or reporting tools still link these SSRIs with QTc prolongation.
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