Clinical toxicology of citalopram after acute intoxication with the sole drug or in combination with other drugs: Overview of 26 cases

Therapeutic Drug Monitoring

Volumn 30, Issue 3, 2008, Pages 365-371

  Jimmink, Afra ^a   Caminada, Klaartje ^b   Hunfeld, Nicole G M ^c   Touw, Daan J ^b,c  

^a UTRECHT UNIVERSITY   (Netherlands)

^b HAGA HOSPITAL   (Netherlands)

^c Central Hospital Pharmacy   (Netherlands)

Author keywords

Citalopram; Intoxication; Poisoning Severity Score; Toxicokinetics

Indexed keywords

ACETYLCYSTEINE; ACTIVATED CARBON; ALCOHOL; ALPRAZOLAM; ANTIBIOTIC AGENT; ANTIDEPRESSANT AGENT; BENZODIAZEPINE DERIVATIVE; CITALOPRAM; DIAZEPAM; FLUMAZENIL; LAXATIVE; LITHIUM; MIRTAZAPINE; NEUROLEPTIC AGENT; NITRAZEPAM; NORDAZEPAM; OXAZEPAM; PARACETAMOL; PIPAMPERONE; PROPRANOLOL; QUETIAPINE; TEMAZEPAM; TRAZODONE; VERAPAMIL; SEROTONIN UPTAKE INHIBITOR;

ADOLESCENT; ADULT; AGED; ARTICLE; ASPIRATION PNEUMONIA; BLOOD; BLOOD SAMPLING; CARDIOTOXICITY; CLINICAL ARTICLE; COMA; CONTROLLED STUDY; CONVULSION; DEMOGRAPHY; DISEASE SEVERITY; DROWSINESS; DRUG BLOOD LEVEL; DRUG ELIMINATION; DRUG HALF LIFE; DRUG INTOXICATION; DRUG OVERDOSE; FATALITY; FEMALE; GASTROINTESTINAL TOXICITY; HEART ARREST; HIGH PERFORMANCE LIQUID CHROMATOGRAPHY; HOSPITAL ADMISSION; HOSPITALIZATION; HUMAN; INGESTION; INTENSIVE CARE UNIT; LENGTH OF STAY; MALE; OUTCOME ASSESSMENT; PARAMETER; PRIORITY JOURNAL; QT PROLONGATION; RESPIRATORY ARREST; SCORING SYSTEM; SEIZURE; SYMPTOM; TACHYCARDIA; TOXICOKINETICS; UNCONSCIOUSNESS; CARDIOVASCULAR DISEASE; CENTRAL NERVOUS SYSTEM DISEASE; CHEMICALLY INDUCED DISORDER; DRUG COMBINATION; DRUG EFFECT; ELECTROCARDIOGRAPHY; FACTUAL DATABASE; GLASGOW COMA SCALE; INTENSIVE CARE; INTOXICATION; KIDNEY FUNCTION TEST; LIVER FUNCTION TEST; METABOLISM; MIDDLE AGED; RESPIRATORY FAILURE; RETROSPECTIVE STUDY;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; CARDIOVASCULAR DISEASES; CENTRAL NERVOUS SYSTEM DISEASES; CHROMATOGRAPHY, HIGH PRESSURE LIQUID; CITALOPRAM; DATABASES, FACTUAL; DRUG COMBINATIONS; ELECTROCARDIOGRAPHY; FEMALE; GLASGOW COMA SCALE; HUMANS; INTENSIVE CARE; KIDNEY FUNCTION TESTS; LIVER FUNCTION TESTS; MALE; MIDDLE AGED; OVERDOSE; RESPIRATORY INSUFFICIENCY; RETROSPECTIVE STUDIES; SEROTONIN UPTAKE INHIBITORS;

MLCS; MLOWN;

EID: 47249120074     PISSN: 01634356     EISSN: 15363694     Source Type: Journal    
DOI: 10.1097/FJC.0b013e3181379ef6     Document Type: Article

References (32)

1. Isbister GK, Bowe SJ, Dawson A, et al. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol. 2004;42:277-285.
2. Kelly CA, Dhaun N, Laing WJ, et al. Comparative toxicity of citalopram and the newer antidepressants after overdose. J Toxicol Clin Toxicol. 2004; 42:67-71.
3. Catalano G, Epstein M, Tsambiras MA, et al. QTc interval prolongation associated with citalopram overdose: a case report and literature review. Clin Neuropharmacol. 2001;24:158-162.
4. Rasmussen SL, Overo KF, Tanghoj P. Cardiac safety of citalopram: prospective trials and retrospective analyses. J Clin Psychopharmacol. 1999;19:407-415.
5. Barbey JT, Roose SP. SSRI safety in overdose. J Clin Psychiatry. 1998; 59:42-48.
6. Bezchlibnyk-Butler K, Alecsic I, Kennedy SH. Citalopram - a review of pharmacological and clinical effects. J Psychiatry Neurosci. 2000;25: 241-254.
7. Luchini D, Morabito G, Centini F, et al. Case report of a fatal intoxication by citalopram. Am J Forensic Med Pathol. 2005;26:352-354.
8. DeVane CL. Metabolism and pharmacokinetics of selective serotonin reuptake inhibitors. Cell Mol Neurobiol. 1999;19:443-466.
9. Prescribing Information (Celexa Label, 2005). US Food and Drug Administration, Center for Drug Evaluation and Research, July 19, 2006. Available at: www.fda.gov/cder/drug/infopage/citalopram/default.htm. Accessed February 20, 2007.
10. Schulz M, Schmoldt A. Therapeutic and toxic blood concentrations of more than 800 drugs and other xenobiotics. Pharmazie. 2003;58: 447-474.
11. Overo KF. Kinetics of citalopram in man; plasma levels in patients. Prog Neuropsychopharmacol Biol Psychiat. 1982;6:311-318.
12. Levy RH, Thummel KE, Troger WF, et al. Metabolic Drug Interactions, 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2000.
13. Wijnands-Kleukers APG, van Zoelen G, de Vries I, et al. A prospective study on intoxications with citalopram. Abstracts of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) XXII International Congress. J Toxicol Clin Toxicol. 2002;40:274-275.
14. Personne M, Persson H, Sjoberg G. Citalopram toxicity. Lancet. 1997; 350:518-519.
15. Ostrom M, Eriksson A, Thorson J, et al. Fatal overdose with citalopram. Lancet. 1996;348:339-340.
16. Jonasson B, Saldeen T. Citalopram in fatal poisoning cases. Forensic Sci Int. 2002;126:1-6.
17. Friberg LE, Isbister GK, Dufful SB. Pharmacokinetic-pharmacodynamic modelling of QT interval prolongation following citalopram overdoses. Br J Clin Pharmacol. 2005;61:177-190.
18. Tarabar AF, Hoffman RS, Nelson LS. Citalopram overdose: late presentation of torsades de pointes (TDP) with cardiac arrest. Abstract of the 2003 North American Congress of Clinical Toxicology (NACCT). J Toxicol Clin Toxicol. 2003;41:676.
19. Kelly CA, Upex A, Spencer EP, et al. Adult respiratory distress syndrome and renal failure associated with citalopram overdose. Hum Exp Toxicol. 2003;22:103-105.
20. Personn HE, Sjoberg GK, Haines JA, et al. Poisoning Severity Score. Grading of acute poisoning. J Toxicol Clin Toxicol. 1998;36:205-213.
21. Wagner GS, Marriott HJL. Marriott's Practical Electrocardiography, 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
22. Proost JH, Meijer DK. MW-Pharm, an integrated software package for drug dosage regimen calculation and therapeutic drug monitoring. Comput Biol Med. 1992;22:155-163.
23. Wilde AAM. Geneesmiddelen en het lange QT-interval. Geneesmiddelbulletin. 2002;36:27-32.
24. Isbister GK, Friberg LE, Dufful SB. Is there value in pharmacokinetic-pharmacodynamic modeling of overdose patients? The example of citalopram and QT prolongation. J Toxicol Clin Toxicol. 2006;44:469.
25. Kirchheiner J, Nickchen K, Bauer M, et al. Pharmacogenetics of antidepressants and antipsychotics: the contribution of allelic variations to the phenotype of drug response. Mol Psychiatry. 2004;9:442-473.
26. Isacsson G, Bergman U. Risks with citalopram in perspective. Lancet. 1996;348:1033.
27. Brion F, Brion N, Durigon M. Fatal overdose with citalopram? Lancet. 1996;348:339-340.
28. Grundemar L, Wohlfart B, Lagerstedt C, et al. Symptoms and signs of severe citalopram overdose. Lancet. 1997;349:1602.
29. Glassman AH. Citalopram toxicity. Lancet. 1997;350:818.
30. Hentschel H, Prasa D, Freitag B, et al. Citalopram poisoning and fatality. Abstracts of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) XXV International Congress. J Toxicol Clin Toxicol. 2005;43:487-488.
31. Neuvonen PJ, Pohjola-Sintonen S, Tacke U, et al. Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses. Lancet. 1993;342:1419.
32. Hale AS. Citalopram is safe. BMJ. 1998;316:1825.