Posted by ed_uk2010 on August 5, 2013, at 15:14:21
In reply to ssri's/heart rythyms, posted by joef on August 2, 2013, at 23:00:42
Citalopram (and possibly escitalopram) can affect cardiac conduction, but they do not normally affect the heart rhythm in people with structurally normal hearts. I would not recommend citalopram for a patient with serious underlying heart disease.
Other SSRIs do not appear to affect cardiac conduction. Sertraline (Zoloft) is a first-line antidepressant for patients with heart disease because it does not affect the heart rhythm and it does not interact significantly with most cardiac drugs.
Serotonin is needed for normal platelet function, and ALL SSRIs are associated with a bleeding risk, which may be relevant to patients on long-term aspirin, clopidogrel (Plavix) or warfarin for cardiovascular disease. The risk of bleeding into the stomach is particularly increased, and some patients are prescribed a proton pump inhibitor (eg. Prilosec) to reduce the risk. (Proton pump inhibitors are only prescribed with SSRIs in those at particularly high risk of gastric bleeding, not otherwise). Non-serotonergic antidepressants are not associated with bleeding, but many have other cardiovascular effects.
poster:ed_uk2010
thread:1048197
URL: http://www.dr-bob.org/babble/20130730/msgs/1048358.html