February 27, 2014 — A study investigating whether the antidepressant Celexa (citalopram) could benefit elderly people with Alzheimer’s disease has found that Celexa may potentially cause heart problems and worsen cognitive function.
The study, published in the Journal of the American Medical Association on February 19, was a clinical trial involving 189 patients with Alzheimer’s disease who were given Celexa or a placebo for 9 weeks between August 2009 and January 2013.
Researchers found that Celexa significantly reduced agitation and caregiver distress compared to a placebo. However, the use of antidepressants to sedate nursing home residents has become controversial and is increasingly seen as a form of abuse.
In addition, 30-mg per day dosage of Celexa was linked to cognitive and cardiac adverse events. According to Dr. Anton Persteinsson of the University of Rochester, clinicians should be “judicious” when prescribing the drug to patients with Alzheimer’s disease, and the dosage should probably be kept below 20-mg per day.
On average, the Celexa group had 18.1-ms QT interval prolongation (the interval between heartbeats). QT interval prolongation can cause fatal arrhythmias (abnormal heart rhythm), ventricular tachycardia, and a rare but life-threatening condition called torsades de pointes.
These findings back up a study published last year in the British Medical Journal, which found that higher doses of Celexa were associated with longer QT interval prolongation. In August 2011 and March 2012, the FDA updated the Safety Warnings for doses above 40-mg per day.