Start Over

Escitalopram causes fewer seizures in human overdose than citalopram.

Authors :: 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 GA
Wilks M
Source :: Clinical toxicology (Philadelphia, Pa.) [Clin Toxicol (Phila)] 2010 Mar; Vol. 48 (3), pp. 207-12.
Publication Year :: 2010
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.<br />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.<br />Methods: Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006.<br />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).<br />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.