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Escitalopram causes fewer seizures in human overdose than citalopram


Yilmaz, Z; Ceschi, A; Rauber-Lüthy, C; Sauer, O; Stedtler, U; Prasa, D; Seidel, C; Hackl, E; Hoffmann-Walbeck, P; Gerber-Zupan, G; Bauer, K; Kupferschmidt, H; Kullak-Ublick, G A; Wilks, M (2010). Escitalopram causes fewer seizures in human overdose than citalopram. Clinical Toxicology, 48(3):207-212.

Abstract

CONTEXT:

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.
OBJECTIVE:

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.
METHODS:

Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.
RESULTS:

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).
DISCUSSION AND CONCLUSIONS:

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.

CONTEXT:

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.
OBJECTIVE:

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.
METHODS:

Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.
RESULTS:

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).
DISCUSSION AND CONCLUSIONS:

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.

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16 citations in Web of Science®
19 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Clinical Pharmacology and Toxicology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2010
Deposited On:10 Mar 2012 15:27
Last Modified:05 Apr 2016 15:26
Publisher:Informa Healthcare
ISSN:1556-3650
Publisher DOI:10.3109/15563650903585937
PubMed ID:20170390
Permanent URL: http://doi.org/10.5167/uzh-56037

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