{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:28:42Z","timestamp":1777858122417,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T00:00:00Z","timestamp":1407888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>Recently, a FDA Safety Communication warned of a dose-dependent risk for QTc prolongation with citalopram, which is metabolized by CYP2C19 of the cytochrome P450 system. We investigate associations between citalopram and escitalopram dose, serum concentration, CYP2C19 phenotype, and QTc. We undertook a retrospective chart review of citalopram or escitalopram patients with the inclusion criteria of consistent medication dose, CYP2C19 phenotype (extensive metabolizers [EM], intermediate metabolizers [IM], poor metabolizers [PM]), and QTc interval on ECG. We further identified 42 citalopram users with citalopram serum concentration measurements and ECG. Regression and one-way ANOVA were used to examine the relationship between citalopram dose, citalopram serum concentration, CYP2C19 phenotype, and QTc interval. Of 75 citalopram patients, the EM group had significantly shorter QTc intervals than a combined IM+PM group (427.1\u00b123.6 ms vs. 440.1\u00b126.6 ms, one-tailed t-test, p=0.029). In the 80 escitalopram cohort, there was no significant difference in QTc between phenotype groups. There was no statistical correlation between citalopram ( p=0.62) or escitalopram ( p=0.30) dose and QTc. QTc was not associated with citalopram serum level ( p=0.45). In contrast to the FDA warning, this study found no association between citalopram\/escitalopram dose and QTc. However, PM of the drug tended to have longer QTc intervals. Our findings suggest cytochrome P450 genotyping in select patients may be helpful to guide medication optimization while limiting harmful effects.<\/jats:p>","DOI":"10.1177\/0269881114543720","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T00:54:42Z","timestamp":1407977682000},"page":"1143-1148","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["CYP2C19 variation, not citalopram dose nor serum level, is associated with QTc prolongation"],"prefix":"10.1177","volume":"28","author":[{"given":"Yingying","family":"Kumar","sequence":"first","affiliation":[{"name":"Mayo Medical School, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Kung","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gen","family":"Shinozaki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,8,13]]},"reference":[{"key":"bibr1-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2012.11.001"},{"key":"bibr2-0269881114543720","first-page":"241","volume":"25","author":"Bezchlibnyk-Butler K","year":"2000","journal-title":"J Psychiatry Neurosci"},{"key":"bibr3-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1007\/BF00432703"},{"key":"bibr4-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1097\/00008571-200212000-00004"},{"key":"bibr5-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(01)00101-8"},{"key":"bibr6-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f288"},{"key":"bibr7-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-200105000-00007"},{"key":"bibr8-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-198707000-00005"},{"key":"bibr9-0269881114543720","unstructured":"Food and Drug Administration (2011) FDA drug safety communication: Abnormal heart rhythms associated with high doses of Celexa (citalopram hydrobromide), Vol. 2013."},{"key":"bibr10-0269881114543720","unstructured":"Food and Drug Administration (2012) FDA drug safety communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses, Vol. 2013."},{"key":"bibr11-0269881114543720","volume-title":"Drug Interactions: Cytochrome P450 Drug Interaction Table, Vol. 2013","author":"Flockhart D","year":"2007"},{"key":"bibr12-0269881114543720","volume-title":"Celexa\u00ae (Citalopram Hydrobromide) Vol. 2013","author":"Forest Laboratories","year":"2013"},{"key":"bibr13-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02546.x"},{"key":"bibr14-0269881114543720","first-page":"13","volume":"49","author":"Howland RH","year":"2011","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"key":"bibr15-0269881114543720","first-page":"13","volume":"49","author":"Howland RH","year":"2011","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"key":"bibr16-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1177\/0091270009337946"},{"key":"bibr17-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120028747"},{"key":"bibr18-0269881114543720","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S22495"},{"key":"bibr19-0269881114543720","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0773.1981.tb01587.x"},{"key":"bibr20-0269881114543720","unstructured":"Laboratories Mayo Clinic (2013) Test Id: Cital Citalopram, Serum. 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