Heart risk link to SSRI antidepressants confirmed

Citalopram and escitalopram, which fall into this drug group, can trigger a heart rhythm disturbance, a new study in the British Medical Journal shows.

UK and US regulators have already warned doctors to be extra careful about which patients they prescribe these medicines to.

And they have lowered the maximum recommended dose.

The UK's Medicines and Healthcare products Regulatory Agency (MHRA) says people with pre-existing heart conditions should have a heart trace before going on these drugs, to check for a rhythm disturbance known as long QT interval.

Experts reassure that complications are very rare and that in most cases the benefits for the patient taking the drug will outweigh the risks.

Long QT

QT interval is measured with an electrocardiogram (ECG) and varies with the heart rate - it gets longer when the heart beats slower and is shorter when the heart beats faster.

Some variation is normal, but if it gets too long it can upset the timing of heartbeat with potentially dire consequences - dizziness, faints and, rarely, sudden death.

To assess how common a problem long QT linked to SSRI use might be, US researchers decided to look at the medical records of more than 38,00 patients from New England.

Most of these patients had been prescribed an SSRI antidepressant, and some were patients who had been prescribed methadone. The researchers included the methadone patients for comparison because this drug (used for pain relief and to wean addicts off heroin) is known to prolong QT interval.

All of the patients had recently had an ECG.

Both citalopram and escitalopram, as well as methadone, was linked with a small but significantly longer QT interval.

This effect increased at higher doses.

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