title: Escitalopram causes fewer seizures in human overdose than citalopram.
abstract: BACKGROUND
  Seizures are a recognized complication of acute overdose with the racemic (1:1 ratio of R- and S-enantiomers) selective serotonin reuptake inhibitor antidepressant citalopram.
  
  
  OBJECTIVE
  We tested the hypothesis that escitalopram (the therapeutically active S-enantiomer of citalopram) causes fewer seizures in overdose than citalopram at comparable doses of the S-enantiomer.
  
  
  METHODS
  Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.
  
  
  RESULTS
  316 citalopram and 63 escitalopram cases were analyzed. Somnolence, nausea, vomiting, tachycardia, QT prolongation, and tremor occurred with similar frequency in both groups. There was a striking difference in the frequency of single and multiple seizures: 43 cases (13.5%) in the citalopram group and 1 case (1.6%) with a single seizure in the escitalopram group (p=0.0065).
  
  
  CONCLUSIONS
  At comparable ingested doses of the S-enantiomer, the symptom profile for citalopram and escitalopram intoxications is similar except for seizures that occur more frequently in citalopram than in escitalopram poisoning.
authors.affiliation: Swiss Toxicological Information Centre, Zurich, Switzerland.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yilmaz
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
authors.forename: Christine
authors.initials: C
authors.lastname: Rauber-Lüthy
authors.forename: Oliver
authors.initials: O
authors.lastname: Sauer
authors.forename: Uwe
authors.initials: U
authors.lastname: Stedtler
authors.forename: Dagmar
authors.initials: D
authors.lastname: Prasa
authors.forename: Carola
authors.initials: C
authors.lastname: Seidel
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hackl
authors.forename: Petra
authors.initials: P
authors.lastname: Hoffmann-Walbeck
authors.forename: Gabriela
authors.initials: G
authors.lastname: Gerber-Zupan
authors.forename: Kathrin
authors.initials: K
authors.lastname: Bauer
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
authors.forename: Gerd-Achim
authors.initials: GA
authors.lastname: Kullak-Ublick
authors.forename: Martin
authors.initials: M
authors.lastname: Wilks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D015283:Citalopram / Q000737:chemistry / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000737:chemistry / Q000506:poisoning*; D013237:Stereoisomerism; D013557:Switzerland; D055815:Young Adult
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors