[Medication associated long QT syndrome].
We report on a 76 year old woman who fainted on her way to the restroom during the night. At the emergency department, a prolonged QT-interval was noticed in addition to sinusbradycardia and marginal hypokalemia. The QT-interval normalized promptly after citalopram was discontinued. Taking into account the clinical picture and the ascertained orthostatic dysregulation, a diagnosis of orthostatic syncope was made. Because of the lengthened QT-interval, drug-induced torsade de pointes ventricular arrhythmia was considered as a differential diagnosis. We describe that citalopram was most probably the cause for the prolonged QT-interval. In our article we discuss the pathophysiology of drug-induced long QT syndrome (LQTS), the most important drugs involved, and finally the prophylaxis and treatment of a TdP ventricular arrhythmia.
Bruggisser
M
M
Abteilung für Klinische Pharmakologie und Toxikologie und Regionales Pharmakovigilance Zentrum Basel.
Rätz Bravo
A
A
Bodmer
M
M
D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D015283:Citalopram / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D000077152:Olanzapine; D012563:Schizophrenia, Paranoid / Q000188:drug therapy*; D019462:Syncope, Vasovagal / Q000175:diagnosis
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D015283:Citalopram; D001569:Benzodiazepines; D000077152:Olanzapine