TGA warns high-dose antidepressant linked to fatal arrhythmia

Today’s TGA notice said citalopram should no longer be used at doses greater than 40 mg per day, after a recent US study found high doses caused QT prolongation.

A maximum daily dose of 20 mg of citalopram applied to patients older than 65, those with liver dysfunction, poor CYP2C19 activity or taking concomitant CYP2C19 inhibitors such as omeprazole, the new advice said.

Hypokalaemia and hypomagnesaemia should be corrected in patients before prescribing citalopram; potassium and magnesium levels should be periodically monitored; and patients at high risk of QT prolongation should have
more frequent ECG monitoring if they are taking citalopram, the TGA said.

Among other new TGA notices, consumers have been advised to stop using a contaminated mouthwash, and more diet pills have been found to contain prescription drugs.

All batches of Colgate Savacol alcohol-free antiseptic mouth and throat rinse were being recalled