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SSRI Side Effects — UKMLA MCQ

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MediumPsychiatrySSRI Side EffectsUKMLAMRCGP AKTPARAPSA

A 29-year-old female patient is prescribed citalopram for moderate depression. Which of the following potential side effects should she be specifically counselled about regarding its potential to affect cardiac rhythm, especially at higher doses or with interacting medications?

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Correct answer: A — QT interval prolongation

Citalopram (and escitalopram) can cause dose-dependent QT interval prolongation, which can increase the risk of serious ventricular arrhythmias like Torsades de Pointes. The MHRA has issued specific warnings regarding maximum doses (e.g., 40mg daily for adults, 20mg for >65 years or hepatic impairment) and use with other QT-prolonging drugs. While other cardiac effects are possible with SSRIs, QT prolongation is a key concern with citalopram.

Reference: BNF: Citalopram (Side-effects, Cautions); MHRA Drug Safety Update on citalopram and escitalopram