title: Citalopram and levosulpiride: a dangerous drug combination for QT prolongation.
abstract: We report the case of an 89-year-old female patient who presented to the emergency department after out-of-hospital cardiac arrest due to polymorphic ventricular tachycardia treated by public access defibrillation. The admission electrocardiogram (ECG) showed extreme QT prolongation (650 milliseconds) with recurrent episodes of nonsustained polymorphic ventricular tachycardia. Intravenous magnesium sulfate therapy was instituted. After history taking, it was found that the patient was on citalopram and that, 2 days prior to admission, she had begun treatment with levosulpiride. This drug combination resulted in marked prolongation of the QT interval that triggered the electrical storm.
authors.affiliation: Department of Cardiology, San Giacomo Hospital, Novi Ligure (AL), Italy. Electronic address: agostisergio@virgilio.it.
authors.forename: Sergio
authors.initials: S
authors.lastname: Agosti
authors.forename: Laura
authors.initials: L
authors.lastname: Casalino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bertero
authors.forename: Alessandro
authors.initials: A
authors.lastname: Burrone
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
authors.forename: Silvana
authors.initials: S
authors.lastname: Morelloni
mesh_terms: D000369:Aged, 80 and over; D015283:Citalopram / Q000009:adverse effects*; D065127:Dopamine D2 Receptor Antagonists; D004347:Drug Interactions; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D015283:Citalopram; D065127:Dopamine D2 Receptor Antagonists; D017367:Selective Serotonin Reuptake Inhibitors; D013469:Sulpiride; C078143:levosulpiride