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Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study.

Publication ,  Journal Article
Fabo, KR; Nye, AM; Gagliardi, JP; Dennis, CR; Muzyk, AJ
Published in: Prim Care Companion CNS Disord
2015

OBJECTIVE: The US Food and Drug Administration (FDA) issued a warning stating that patients older than 60 years are not recommended to receive doses of citalopram exceeding 20 mg daily due to concerns of corrected QT (QTc) prolongation. The purpose of this study is to assess the impact of the FDA warning on prescribing patterns of citalopram in patients 60 years of age and older. METHOD: This is a retrospective cohort study of hospitalized patients 60 years of age and older prescribed citalopram from October 24, 2010, to August 24, 2011 and from November 24, 2011, to September 24, 2012. Records were examined for the presence of baseline risk factors for QTc prolongation and torsades de pointes. RESULTS: The issuance of an FDA warning was not associated with an observable change in prescribing patterns of citalopram. A total of 98.8% of patients had at least 1 risk factor for QTc prolongation. No significant difference in the total number of risk factors was seen between groups (P = .915). No differences were seen in risk factors prewarning and postwarning, except a higher percentage had left ventricular hypertrophy (P = .001) or history of syncope (P = .043) prior to the warning. More subjects were prescribed concomitant proarrhythmic medications (P = .009) after the FDA warning was issued. Similar percentages of each group were receiving daily dosages > 20 mg of citalopram (P = .600). CONCLUSIONS: The issuance of an FDA warning did not produce observable changes in prescribing patterns of citalopram. Modifiable risk factors and optimal dosing may be targets of interventions aimed at promoting safer use of citalopram.

Duke Scholars

Published In

Prim Care Companion CNS Disord

DOI

ISSN

2155-7772

Publication Date

2015

Volume

17

Issue

1

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fabo, K. R., Nye, A. M., Gagliardi, J. P., Dennis, C. R., & Muzyk, A. J. (2015). Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study. Prim Care Companion CNS Disord, 17(1). https://doi.org/10.4088/PCC.14m01657
Fabo, Karyn R., Ann Marie Nye, Jane P. Gagliardi, Christopher R. Dennis, and Andrew J. Muzyk. “Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study.Prim Care Companion CNS Disord 17, no. 1 (2015). https://doi.org/10.4088/PCC.14m01657.
Fabo KR, Nye AM, Gagliardi JP, Dennis CR, Muzyk AJ. Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study. Prim Care Companion CNS Disord. 2015;17(1).
Fabo, Karyn R., et al. “Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study.Prim Care Companion CNS Disord, vol. 17, no. 1, 2015. Pubmed, doi:10.4088/PCC.14m01657.
Fabo KR, Nye AM, Gagliardi JP, Dennis CR, Muzyk AJ. Evaluation of Changes in Citalopram Prescribing Patterns Following a US Food and Drug Administration Alert: A Retrospective Cohort Study. Prim Care Companion CNS Disord. 2015;17(1).

Published In

Prim Care Companion CNS Disord

DOI

ISSN

2155-7772

Publication Date

2015

Volume

17

Issue

1

Location

United States