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RESEARCH PRODUCT

Escitalopram causes fewer seizures in human overdose than citalopram

Dagmar PrasaG.a. Kullak-ublickElisabeth HacklChristine Rauber-lüthyUwe StedtlerPetra Hoffmann-walbeckKathrin BauerGabriela Gerber-zupanCarola SeidelAlessandro CeschiHugo KupferschmidtZeynep YilmazO. SauerMartin F. Wilks

subject

AdultMalePoison Control CentersAdolescentNauseaSerotonin reuptake inhibitor610 Medicine & healthCitalopramCitalopramToxicologyDrug overdosebehavioral disciplines and activitiesQT intervalYoung AdultSeizuresGermanymental disordersmedicineHumansEscitalopramAgedRetrospective StudiesAged 80 and over3005 ToxicologyStereoisomerismGeneral MedicineMiddle Agedmedicine.disease10199 Clinic for Clinical Pharmacology and ToxicologyAustriaAnesthesiaVomitingAntidepressantFemaleDrug Overdosemedicine.symptomPsychologySelective Serotonin Reuptake InhibitorsSwitzerlandmedicine.drug

description

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.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.Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.316 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).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.

yearjournalcountryeditionlanguage
2010-02-23
10.5167/uzh-56037https://doi.org/10.5167/uzh-56037