ArticleBritish journal of clinical pharmacology2010
Evaluation of a QT nomogram for risk assessment after antidepressant overdose.
Article in British journal of clinical pharmacology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Measurement and Management of QT Interval Prolongation for General Physicians.Journal of general internal medicine · 2020Review
- QT interval prolongation andTherapeutic advances in drug safety · 2020Article
- Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate.PloS one · 2020Article
- Lack of relationship between plasma levels of escitalopram and QTc-interval length.European archives of psychiatry and clinical neuroscience · 2017Article
- Solifenacin linked QT interval prolongation and torsades de pointes.Therapeutic advances in drug safety · 2017Article
- Observational
- Citalopram and escitalopram: adverse cardiac outcomes in medically ill inpatients.Therapeutic advances in drug safety · 2016Article
- Propofol-associated QTc prolongation.Therapeutic advances in drug safety · 2016Article
- QTc interval prolongation and torsade de pointes associated with second-generation antipsychotics and antidepressants: a comprehensive review.CNS drugs · 2014Review
- Mirtazapine overdose is unlikely to cause major toxicity.Clinical toxicology (Philadelphia, Pa.) · 2014Observational
- Selective serotonin reuptake inhibitors and torsade de pointes: new concepts and new directions derived from a systematic review of case reports.Therapeutic advances in drug safety · 2013Article
- Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice.British journal of clinical pharmacology · 2013Review
- A review of the suitability of duloxetine and venlafaxine for use in patients with depression in primary care with a focus on cardiovascular safety, suicide and mortality due to antidepressant overdose.Therapeutic advances in psychopharmacology · 2013Article
- Citalopram and cardiac toxicity.European journal of clinical pharmacology · 2013Review
- Drug-induced QT interval prolongation: mechanisms and clinical management.Therapeutic advances in drug safety · 2012Review
- Utility of the electrocardiogram in drug overdose and poisoning: theoretical considerations and clinical implications.Current cardiology reviews · 2012Review
- Comment on "Serial monitoring of lead aVR in patients with prolonged unconsciousness following tricyclic antidepressant overdose".Psychiatry investigation · 2012Article
- Clinical use of antidepressant therapy and associated cardiovascular risk.Drug, healthcare and patient safety · 2012Article
- Towards a better understanding of QT interval variability.Therapeutic advances in drug safety · 2011Review
- Editors' pick 2010.British journal of clinical pharmacology · 2011Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsA QT-heart rate nomogram has recently been proposed as a means of identifying patients at risk of torsades de pointes after antidepressant overdose, based on published cases of drug-induced torsades de pointes. The present study sought to examine the performance of the nomogram in patients who ingest an antidepressant overdose but do not develop arrhythmia.
methodsA retrospective case control study of patients presenting to hospital after overdose of citalopram, mirtazapine and venlafaxine was carried out. The primary outcome variable was QT higher than the nomogram, and was compared with occurrence of QT(c) (QT corrected by Bazett's formula) greater than ≥440 ms and QT(c) ≥500 ms, with comparison between drugs. Data are expressed as proportions in each group with 95% confidence intervals.
resultsThere were 858 electrocardiograms from 541 patients. QT was higher than the nomogram in 2.4% (1.4, 4.1%), whereas QT(c) was ≥440 ms in 23.1% (95% CI 19.8, 26.8%), and QT(c) was ≥500 ms in 1.1% (0.5, 2.5%). Citalopram overdose was more likely to be associated with QT higher than the nomogram compared with the other agents (difference 7.0%, 95% CI 2.9, 11.9%, P = 0.001) and more likely to be associated with QT(c) ≥440 ms (difference = 11.0%, 95% CI 2.6, 19.0%, P = 0.013).
conclusionsThe QT nomogram was associated with a lower false positive rate than widely accepted QT(c) criteria, and allowed detection of different effects of individual drugs. The nomogram offers potential advantages over QT(c) criteria and merits further investigation in a clinical setting.
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