A 65-year-old woman with depression is started on citalopram. Which ECG change is a known dose-related adverse effect that limits the maximum recommended dose?

• A PR interval prolongation
• B ST segment elevation
• C Left bundle branch block
• D QTc interval prolongation ✓

Explanation

Citalopram causes dose-dependent QTc prolongation, increasing the risk of torsades de pointes. Regulatory guidelines recommend a maximum dose of 20 mg/day in patients over 60 years and avoidance in those with congenital long QT syndrome. Baseline and follow-up ECGs are advised.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.