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Sinus arrest, possibly due to an interaction, and other toxicities: case report A 50-year-old man with depression developed different toxicities during treatment with citalopram [time to onset not clearly stated], and sinus arrest after citalopram was replaced with sertraline; sinus arrest was attributed to sertraline alone or to an interaction with citalopram. The man started receiving citalopram 10 mg/day [route not stated]. Due to side effects including nausea, dizziness and insomnia, citalopram was stopped after 1 month of treatment, and his therapy was switched to sertraline 50 mg/day [route not stated]. He experienced a syncope on the fourth day of sertraline therapy and was hospitalised. During the first day, he experienced five episodes of sinus arrest with loss of consciousness for 5 seconds. An ECG showed basic sinus rhythm, and Holter monitoring was normal. A sertraline-related reaction was suspected. He was monitored at an ICU for 10 days without recurrence of syncopes, and was subsequently followed as an outpatient. Author comment: "The Naranjo Adverse Drug Reaction (ADR) Probability Scale indicated a ‘probable’ relationship between the adverse effect (sinus arrest) and sertraline therapy in this patient, whereas the Drug Interaction Probability Scale indicated a ‘possible’ relationship between the citalopram and sertraline therapy." Kocabay G, et al. Sinus arrest due to sertraline. Clinical Cardiology 33: E114-E115, No. 6, Jun 2010. Available from: URL: http://dx.doi.org/10.1002/ 803030133 clc.20647 - Turkey

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Reactions 7 Aug 2010 No. 1313