Citalopram and levosulpiride: a dangerous drug combination for QT prolongation

Am J Emerg Med. 2013 Nov;31(11):1624.e1-2. doi: 10.1016/j.ajem.2013.06.030. Epub 2013 Jul 27.


We report the case of an 89-year-old female patient who presented to the emergency department after out-of-hospital cardiac arrest due to polymorphic ventricular tachycardia treated by public access defibrillation. The admission electrocardiogram (ECG) showed extreme QT prolongation (650 milliseconds) with recurrent episodes of nonsustained polymorphic ventricular tachycardia. Intravenous magnesium sulfate therapy was instituted. After history taking, it was found that the patient was on citalopram and that, 2 days prior to admission, she had begun treatment with levosulpiride. This drug combination resulted in marked prolongation of the QT interval that triggered the electrical storm.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Citalopram / adverse effects*
  • Dopamine D2 Receptor Antagonists*
  • Drug Interactions
  • Electrocardiography
  • Emergency Service, Hospital
  • Female
  • Heart / drug effects
  • Heart / physiopathology
  • Humans
  • Out-of-Hospital Cardiac Arrest / chemically induced*
  • Out-of-Hospital Cardiac Arrest / diagnosis
  • Out-of-Hospital Cardiac Arrest / physiopathology
  • Serotonin Uptake Inhibitors / adverse effects*
  • Sulpiride / adverse effects
  • Sulpiride / analogs & derivatives*


  • Dopamine D2 Receptor Antagonists
  • Serotonin Uptake Inhibitors
  • Citalopram
  • Sulpiride
  • levosulpiride