title: Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study.
abstract: BACKGROUND
  The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia.
  
  
  METHODS
  We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701) or escitalopram (n = 38 436), compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620). After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days.
  
  
  RESULTS
  Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29), and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18). Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68), but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18).
  
  
  CONCLUSIONS
  Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia.
authors: Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.
authors: Elena
authors: E
authors: Qirjazi
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Eric
authors: E
authors: McArthur
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Danielle M
authors: DM
authors: Nash
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
authors: Stephanie N
authors: SN
authors: Dixon
authors: Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.|Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
authors: Matthew A
authors: MA
authors: Weir
authors: Division of Geriatric Psychiatry, Department of Psychiatry, Western University, London, Ontario, Canada.|Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada.
authors: Akshya
authors: A
authors: Vasudev
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Racquel
authors: R
authors: Jandoc
authors: Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada.
authors: Lorne J
authors: LJ
authors: Gula
authors: Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Matthew J
authors: MJ
authors: Oliver
authors: Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.|Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Ron
authors: R
authors: Wald
authors: Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
authors: Amit X
authors: AX
authors: Garg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D015283:Citalopram / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D017180:Tachycardia, Ventricular / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors