ArticleBritish journal of clinical pharmacology2012
Population pharmacokinetics and pharmacodynamics of escitalopram in overdose and the effect of activated charcoal.
Article in British journal of clinical pharmacology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 35 citations in OpenAlex.
- Application of escitalopram population pharmacokinetic repository: a step to precision dosing.Translational psychiatry · 2026Article
- A Step Toward Precision Dosing of Escitalopram in Chinese Patients: An External Evaluation of Published Population Pharmacokinetic Models.Drug design, development and therapy · 2025Article
- Escitalopram Personalized Dosing: A Population Pharmacokinetics Repository Method.Drug design, development and therapy · 2023Review
- Population pharmacokinetics model for escitalopram in Chinese psychiatric patients: effect of CYP2C19 and age.Frontiers in pharmacology · 2022Article
- Delay differential equations based models in NONMEM.Journal of pharmacokinetics and pharmacodynamics · 2021Article
- A population pharmacokinetic model for escitalopram and its major metabolite in depressive patients during the perinatal period: Prediction of infant drug exposure through breast milk.British journal of clinical pharmacology · 2020Article
- Escitalopram population pharmacokinetics in people living with human immunodeficiency virus and in the psychiatric population: Drug-drug interactions and probability of target attainment.British journal of clinical pharmacology · 2019Observational
- Restarting antidepressant and antipsychotic medication after intentional overdoses: need for evidence-based guidance.Therapeutic advances in psychopharmacology · 2019Review
- Activated charcoal for acute overdose: a reappraisal.British journal of clinical pharmacology · 2016Review
- Effect of Catnip Charcoal on the In Vivo Pharmacokinetics of the Main Alkaloids of Rhizoma Coptidis.Evidence-based complementary and alternative medicine : eCAM · 2016Article
- Drug-induced proarrhythmia: risk factors and electrophysiological mechanisms.Nature reviews. Cardiology · 2016Review
- The pharmacokinetics of sertraline in overdose and the effect of activated charcoal.British journal of clinical pharmacology · 2015Article
- QTc interval prolongation and torsade de pointes associated with second-generation antipsychotics and antidepressants: a comprehensive review.CNS drugs · 2014Review
- Clinical relevance of the (S)-citalopram-omeprazole interaction in geriatric patients.British journal of clinical pharmacology · 2014Article
- Early QT assessment--how can our confidence in the data be improved?British journal of clinical pharmacology · 2013Review
- Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice.British journal of clinical pharmacology · 2013Review
- Cardiac safety, drug-induced QT prolongation and torsade de pointes (TdP).British journal of clinical pharmacology · 2012Article
- Top-down, Bottom-up and Middle-out Strategies for Drug Cardiac Safety Assessment via Modeling and Simulations.Current pharmacology reportsReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo describe the pharmacokinetics and pharmacodynamics (PKPD) of escitalopram in overdose and its effect on QT prolongation, including the effectiveness of single dose activated charcoal (SDAC).
methodsThe data set included 78 escitalopram overdose events (median dose, 140mg [10-560mg]). SDAC was administered 1.0 to 2.6 h after 12 overdoses (15%). A fully Bayesian analysis was undertaken in WinBUGS 1.4.3, first for a population pharmacokinetic (PK) analysis followed by a PKPD analysis. The developed PKPD model was used to predict the probability of having an abnormal QT as a surrogate for torsade de pointes.
resultsA one compartment model with first order input and first-order elimination described the PK data, including uncertainty in dose and a baseline concentration for patients taking escitalopram therapeutically. SDAC reduced the fraction absorbed by 31% and reduced the individual predicted area under the curve adjusted for dose (AUC(i) /dose). The absolute QT interval was related to the observed heart rate with an estimated individual heart rate correction factor (α= 0.35). The heart rate corrected QT interval (QT(c) ) was linearly dependent on predicted escitalopram concentration [slope = 87ms/(mgl(-1) )], using a hypothetical effect-compartment (half-life of effect-delay, 1.0h). Administration of SDAC significantly reduced QT prolongation and was shown to reduce the risk of having an abnormal QT by approximately 35% for escitalopram doses above 200mg.
conclusionsThere was a dose-related lengthening of the QT interval that lagged the increase in drug concentration. SDAC resulted in a moderate reduction in fraction of escitalopram absorbed and reduced the risk of the QT interval being abnormal.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.