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Cited by 174Cardiac electrophysiology and arrhythmiasCardiac Health and Mental HealthTreatment of Major Depression

The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index.

A Comparison of the Risk of QT Prolongation Among SSRIs

Funk, Kylee A., Bostwick, Jolene R.·2013·Annals of Pharmacotherapy
DOI 10.1177/1060028013501994
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Abstract

Objective : To report QT prolongation potential in selective serotonin reuptake inhibitors (SSRIs) in order to advise clinicians on safe use of SSRIs other than citalopram in light of citalopram warnings. Data Sources : Primary literature and case reports were identified through a systematic search. Data from drug manufacturers, package inserts, and the ArizonaCERT database were also utilized. Study Selection and Data Extraction : English-language studies and case reports were included. Data Synthesis : Studies demonstrate possible dose-related clinically significant QT prolongation with escitalopram. 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. However, case reports or reporting tools still link these SSRIs with QTc prolongation. Fluoxetine, escitalopram, and sertraline used in post–acute coronary syndrome patients did not demonstrate risk of QTc prolongation. Conclusion : For clinicians who choose not to use citalopram due to recent Food and Drug Administration (FDA) recommendations, other antidepressants within this class may be considered. When citalopram is not utilized based on risk factors for TdP, use of escitalopram is not likely the safest alternative. 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. Therefore, choice of an alternative SSRI should be based on individual risk factors for arrhythmias and other patient-specific factors.

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  1. Guy S, Silke B. The electrocardiogram as a tool for therapeutic monitoring: a critical analysis. J Clin Psychiatry. 1990;51(suppl B):37-39.
  2. 10.1345/aph.16185. · DOI · Paper page

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Metadata

Authors
Funk, K. A., & Bostwick, J. R.
Affiliations
University of Michigan (US)
ORCID
Venue
Annals of Pharmacotherapy
Publisher
SAGE Publications
Published
2013-10
Volume
47
Issue
10
Pages
1330-1341
ISSN
  • 0012-6578 (ISSN-L)
  • 1060-0280
  • 1542-6270
DOI
10.1177/1060028013501994
OpenAlex
W2018099384
Cited by
174
References
52
Citations by year
2026: 12 · 2025: 19 · 2024: 22 · 2023: 20 · 2022: 22 · 2021: 13 · 2020: 6 · 2019: 11 · 2018: 8 · 2017: 11 · 2016: 12 · 2015: 11 · 2014: 6
FWCI
6.57
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Annals of Pharmacotherapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords
QT prolongation, selective serotonin reuptake inhibitors, citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, paroxetine, torsades de pointes, QTc interval, antidepressant safety, arrhythmia risk, acute coronary syndrome, FDA warning
MeSH terms
Antidepressive Agents, Humans, Long QT Syndrome, Risk, Selective Serotonin Reuptake Inhibitors

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