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QT interval prolongation after sertraline overdose: a case report.
Rudolf A de Boer1, Tonnis H van Dijk, Nicole D Holman
1Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands. rudolfdeboer@wanadoo.nl
BMC Emergency Medicine
|July 21, 2005
Summary
Selective serotonin reuptake inhibitors (SSRIs) can cause QT interval prolongation in overdose. This case study shows sertraline overdose led to prolonged QT intervals, which normalized after drug discontinuation.
Area of Science:
- Pharmacology
- Cardiology
- Clinical Toxicology
Background:
- Selective serotonin reuptake inhibitors (SSRIs) are widely used antidepressants.
- SSRIs are generally well-tolerated with lower cardiovascular toxicity than tricyclic antidepressants.
- Potential for QT interval prolongation with SSRI overdose requires investigation.
Purpose of the Study:
- To report a case of QT interval prolongation associated with sertraline overdose.
- To investigate the cardiovascular effects of a significant sertraline overdose.
Main Methods:
- A case presentation of a patient with attempted suicide involving overdoses of sertraline, diazepam, and temazepam.
- Electrocardiogram (ECG) monitoring to assess QT interval.
- Discontinuation and subsequent re-challenge with sertraline to evaluate causality.
Main Results:
- The patient presented with normal QT interval on admission.
- ECG on the following day showed significant QTc interval prolongation (up to 525 ms).
- QT interval normalized after sertraline discontinuation and remained normal upon re-challenge at a therapeutic dose.
Conclusions:
- Sertraline overdose may be associated with QT interval prolongation.
- The cardiovascular effects of sertraline overdose can be reversible.
- Further studies are warranted to understand the dose-dependent cardiotoxicity of SSRIs.