Risk Assessment of QT Prolongation with Citalopram and Escitalopram: An Evidence Based Review
Bibliographic record
Abstract
Recent health advisories have identified a risk of QT prolongation with the commonly used antidepressants citalopram (Celexa®) and escitalopram (Cipralex®). Pertinent literature was searched for, uncovered, and critically assessed to determine the comparative risk of arrhythmias or death between citalopram and escitalopram. No data were found directly addressing our clinical question by evaluating the two antidepressants for their comparative risk. However, several randomized and crossover trials, as well as a cohort study, were found to address questions regarding the cardiovascular risk of each agent. Available studies indicate a dose-related lengthening of the QT interval with both antidepressants, suggesting that these agents should be used at lower doses in patients with risk factors for arrhythmias. Overall, the evidence suggests that there is no clear advantage to using escitalopram in place of citalopram to minimize the risk of QT prolongation resulting in fatal arrhythmias.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".