Dear Doctor Letters regarding citalopram and escitalopram: guidelines vs real-world data
DOKPE
- de Bardeci, Mateo Ludwig Maximilian University, Munich, Germany
- Greil, Waldemar ORCID Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
- Stassen, Hans Psychiatric University Hospital (KPPP), Zurich, Switzerland
- Willms, Jamila Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
- Köberle, Ursula Arzneimittelkommission der Deutschen Ärzteschaft, Berlin, Germany
- Bridler, René Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
- Hasler, Gregor ORCID University of Fribourg
- Kasper, Siegfried Medical University of Vienna, Austria
- Rüther, Eckart Ludwig Maximilian University, Munich, Germany
- Bleich, Stefan Hannover Medical School, Germany
- Toto, Sermin Hannover Medical School, Germany
- Grohmann, Renate Ludwig Maximilian University, Munich, Germany
- Seifert, Johanna Hannover Medical School, Germany
- 2022
Published in:
- European Archives of Psychiatry and Clinical Neuroscience. - Heidelberg : Spinger Nature. - 2022, vol. 273, p. 65-74
Citalopram
Dear Doctor Letter
DDL
Direct Healthcare Professional Communications
DHPCs
QTc prolongation
Torsade de Pointes
TdP
English
Dear Doctor Letters (DDLs, Direct Healthcare Professional Communications) from 2011 provided guidance regarding QTc-prolonging effects with risk of torsade de pointes during treatment with citalopram and escitalopram. This study examines the DDLs' effects on prescription behavior. Data from 8842 inpatients treated with citalopram or escitalopram with a primary diagnosis of major depressive disorder (MDD) were derived from a European pharmacovigilance study (Arzneimittelsicherheit in der Psychiatrie, AMSP) from 2001 to 2017. It was examined to what extent new maximum doses were adhered to and newly contraindicated combinations with QTc-prolonging drugs were avoided. In addition, the prescriptions of psychotropic drugs before and after DDLs were compared in all 43,480 inpatients with MDD in the data set. The proportion of patients dosed above the new limit decreased from 8 to 1% in patients ≤ 65 years and from 46 to 23% in patients > 65 years old for citalopram versus 14-5% and 47-31% for escitalopram. Combinations of es-/citalopram with other QTc-prolonging psychotropic drugs reduced only insignificantly (from 35.9 to 30.9%). However, the proportion of patients with doses of quetiapine > 150 mg/day substantially decreased within the combinations of quetiapine and es-/citalopram (from 53 to 35%). After the DDLs, prescription of citalopram decreased and of sertraline increased. The DDLs' recommendations were not entirely adhered to, particularly in the elderly and concerning combination treatments. This might partly be due to therapeutic requirements of the included population. Official warnings should consider clinical needs.
- Faculty
- Faculté des sciences et de médecine
- Department
- Master en médecine
- Language
-
- English
- Classification
- Pathology, clinical medicine
- License
- CC BY
- Open access status
- gold
- Identifiers
-
- DOI 10.1007/s00406-022-01392-x
- ISSN 0940-1334
- Persistent URL
- https://folia.unifr.ch/unifr/documents/327284
Statistics
Document views: 15
File downloads:
- debardecietal.2022.pdf: 24