Citalopram hydrobromide (Celexa) is an serotonin reuptake inhibitor (SSRI) that can cause prolongation of the QT interval. In order to avoid complications the drug should be avoided in some patients and be prescribed at a reduced dose in others.


Contraindications to taking citalopram:

(1) therapy with another drug that prolongs the QT interval

(2) congenital long QT syndrome

(3) QT interval above the upper limit of normal

(4) bradycardia

(5) hypokalemia

(6) hypomagnesemia

(7) history of recent acute myocardial infarction

(8) decompensated heart failure


Risk factors for prolongation of the QT interval while on citalopram:

(1) age > 60 years

(2) hepatic dysfunction

(3) poor CYP2C19 metabolizer

(4) therapy with a drug that inhibits CYP2C19 (cimetidine, other)


Number of Risk Factors

Maximum Daily Dose


40 mg

1 or more

20 mg



• A patient with 3 or 4 risk factors should be considered for an alternative drug with less risk.


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