Antidepressants and QT prolongation

A very thorough review of the effects of antidepressant treatment upon the QT interval is an excellent resource for clinicians dealing with this matter in the care of older people. TCAs and citalopram are associated with the greatest risk for QT prolongation in older people, other SSRIs and SNRIs do not appear to pose any significant risk in isolation, and bupropion is probably safe also. Monitoring the ECG before initiating any agent that may prolong the QTc interval, as well as after the onset of new bradyarrhythmias, or severe hypokalaemia or hypomagnaesemia, or after overdose of known proarrhythmics agents is suggested. The full report, published in Therapeutic Advances in Drug Safety, can be viewed here.