Worried about citalopram increasing the risk of Long QT

[WildChinchilla]

I recently discovered that Citalopram increases the risk of Long QT Syndrome. After discovering this I immediately felt more anxious. This in itself worried me, as stress can increase the risk of Long QT too.


For those who don't know what "Long QT" is, it's a heart condition that is a relatively common cause of Sudden Arrhythmic Death Syndrome, which kills about 500 people a year in the UK. Although SADS is relatively rare, the fear of it causes me a lot of anxiety.


It seemed pretty strange that doctors should prescribe such a medication to people suffering from health anxiety, especially when my doctor knows that mine is centred around the heart, but after a few days I managed to calm myself, as I'm only on 10mg per day, which is the very lowest dose.


However, I still worry about it, particularly when I learn that other things can also increase the risk of Long QT. For example, the quinine in tonic water can increase the risk of Long QT, and as someone who enjoys drinking tonic water, and likes the occasional G and T, I now worry that the quinine in tonic water, coupled with Citalopram, may doubly enhance the risk of Long QT. Keep in mind that only 2 litres of tonic water has the equivalent amount of quinine as the typical medical dose used to treat malaria.

Another common cause of Long QT is exercise. Exercise already increases my anxiety because of the way it speeds up heart rate, so now that I know that I'm taking a medication which increases Long QT, exercise seems even more worrying. Yes, I'm on a low dose, but surely a low dose still increases the risk of it, if only slightly, and if I'm on it while doing something else that increases the chances of Long QT, such as doing exercise or drinking tonic water (or both), then that risk will increase. If I then have an anxiety attack, the risk will surely increase even more.

I'm not sure what to do. Should I speak to my doctor about changing the medication, or just try not to worry about it?

[Careful1]

There are over 100 medications that have the potential to cause a prolonged QT interval but just because they can doesn’t mean they will. Exercise does not cause LQTS but it can be a problem in people that have it. There are different types of LQTS and the triggers are different for each type.
Acquired LQTS is reversible, If whatever is causing it is taken out the equation the QT interval will go back to normal.

I have taken medications that list a prolonged QT interval as a potential side effect and I never had any problems despite having a history of arrhythmia’s, now that’s not to say that someone else wouldn’t but the majority of people will not experience this side effect. It seems to be more of a risk in people with congenital LQTS and in people without it if they are taking more then one medication that has been shown to prolong the QT interval.

If your concerned about it have a discussion with your doctor, a simple EKG would give him/her the information they need. In the mean time stop googling. LQTS is a rare and complex condition and if you don’t have congenital LQTS a lot of what you read online wouldn’t apply to you.