title: Drug-Induced QT Prolongation as a Result of an Escitalopram Overdose in a Patient with Previously Undiagnosed Congenital Long QT Syndrome.
abstract: We present a case of drug-induced QT prolongation caused by an escitalopram overdose in a patient with previously undiagnosed congenital LQTS. A 15-year-old Caucasian female presented following a suicide attempt via an escitalopram overdose. The patient was found to have a prolonged QT interval with episodes of torsades de pointes. The patient was admitted to the telemetry unit and treated. Despite the resolution of the torsades de pointes, she continued to demonstrate a persistently prolonged QT interval. She was seen by the cardiology service and diagnosed with congenital long QT syndrome. This case illustrates the potential for an escitalopram overdose to cause an acute QT prolongation in a patient with congenital LQTS and suggests the importance of a screening electrocardiogram prior to the initiation of SSRIs, especially in patients at high risk for QT prolongation.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri Kansas City School of Medicine, 2301 Holmes Street, Kansas City, MO 64108, USA.
authors.forename: Paul
authors.identifier: 0000-0003-3895-7804
authors.initials: P
authors.lastname: Singh
authors.affiliation: University of Missouri Kansas City School of Medicine, 2301 Holmes Street, Kansas City, MO 64108, USA.
authors.forename: J Martin
authors.initials: JM
authors.lastname: Maldonado-Duran
references.citation: Ann Emerg Med. 2009 Sep;54(3):404-8
references.pmid: 19556032
references.citation: Eur Psychiatry. 2005 Jan;20(1):82
references.pmid: 15642453
references.citation: Can J Cardiol. 2008 Jul;24(7):e38-40
references.pmid: 18612505
references.citation: Circulation. 2001 Jan 2;103(1):89-95
references.pmid: 11136691
references.citation: Circulation. 2009 Nov 3;120(18):1761-7
references.pmid: 19841298
references.citation: Circ Arrhythm Electrophysiol. 2009 Oct;2(5):511-23
references.pmid: 19843919
references.citation: J Child Adolesc Psychopharmacol. 2008 Jun;18(3):297-8
references.pmid: 18582186
references.citation: Int J Cardiol. 2008 Dec 17;131(1):e33-4
references.pmid: 17919753
references.citation: J Toxicol Clin Toxicol. 2004;42(3):277-85
references.pmid: 15362595
references.citation: J Physiol. 1920 Feb 20;53(5):320-39
references.pmid: 16993419
references.citation: Front Pediatr. 2013 Nov 20;1:39
references.pmid: 24400285