SELECTIVE SEROTONIN REUPTAKE INHIBITORS: A SAFETY ISSUE (SYSTEMATIC REVIEW)
https://doi.org/10.52485/19986173_2024_4_133
Abstract
The authors searched, analyzed and systematized the results of domestic and foreign studies of SSRI-induced QT prolongation and the risk of Torsades de Pointes (full-text versions of original articles, clinical cases, systemic reviews, meta-analyses, Cochrane reviews) in Russian and English languages available in bibliographic databases (e-LIBRARY, PubMed, Scopus, Springer, ClinicalKeys, OxfordPress, Google Scholar, MedCredit, DrugBank, PharmGKB) to update the knowledge of practicing neurologists, cardiologists, clinical pharmacologists and general practitioners (physicians, pediatricians) about the possibility of predicting and preventing life-threatening cardiac adverse reactions. From the obtained results it can be judged that escitalopram and citalopram have a potentially high risk. Also, some studies show significantly affects the QT interval at therapeutic and toxic doses of sertraline. The safety was demonstrated by fluvoxamine and fluoxetine. Studies of these SSRIs didn’t show a statistically significant increase the QT interval.
About the Authors
N. A. Shnayder
Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre of Psychiatry and Neurology;
Russian Federation
Russian Federation
Shnayder N.A., Doctor of Medical Sciences, professor;Neurologist, functional diagnostics physician, psychotherapist, chief researcher, deputy head of the Institute of Personalized Psychiatry and Neurology, National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev, St. Petersburg, head of the personalized neurology group; leading researcher of the shared use center "Molecular and cellular technologies" of Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky,
Elibrary ID: 185359;
Researcher ID: M-7084-2014;
Scopus ID: 24503222300
3 Bekhterev St., Saint Petersburg, Russia, 192019;
1 Partizana Zheleznyaka str., Krasnoyarsk, Russia, 660022
E. A. Makarov
Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre of Psychiatry and Neurology
Russian Federation
Russian Federation
Makarov E.A., Neurologist, resident of the National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev
3 Bekhterev St., Saint Petersburg, Russia, 192019
A. V. Kidyaeva
Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre of Psychiatry and Neurology;
State Psychiatric Hospital of St. Nicholas the Wonderworker
Russian Federation
Russian Federation
Kidyaeva A.V., Psychiatrist of the St. Petersburg State Healthcare Institution "St. Nicholas the Wonderworker Psychiatric Hospital"; Young researcher of the Institute of Personalized Psychiatry and Neurology, National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev
3 Bekhterev St., Saint Petersburg, Russia, 192019;
126 Moika River emb., Saint Petersburg, Russia, 190121
V. V. Grechkina
Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre of Psychiatry and Neurology;
St. Petersburg Psychiatric Hospital No. 6, City Epileptology Center
Russian Federation
Russian Federation
Grechkina V.V., Neurologist, St. Petersburg State Healthcare Institution City Psychiatric Hospital No. 6, City Epileptology Cente; Young researcher of the Institute of Personalized Psychiatry and Neurology, National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev
3 Bekhterev St., Saint Petersburg, Russia, 192019;
13 Obvodny Canal Embankment, St. Petersburg, Russia, 191167
M. M. Petrova
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
Russian Federation
Russian Federation
Petrova M.M., Doctor of Medical Sciences, Professor, Cardiologist, Head of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education
Researcher ID: M-3898-2014;
1 Partizana Zheleznyaka str., Krasnoyarsk, Russia, 660022
R. F. Nasyrova
Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Centre of Psychiatry and Neurology;
Tula State University
Russian Federation
Russian Federation
Nasyrova R.F., Doctor of Medical Sciences, Clinical pharmacologist, psychiatrist, chief researcher, head of the Institute of Personalized Psychiatry and Neurology, National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev;
Elibrary ID: 551543; S
Researcher ID: B-1259-2014;
Scopus ID: 15769218400
3 Bekhterev St., Saint Petersburg, Russia, 192019;
92 Lenin ave., Tula, Russia, 300012
References
1. Edinoff A.N., Akuly H.A., Hanna T.A., et al. Selective serotonin reuptake inhibitors and adverse effects: A narrative review. Neurol Int. 2021;13(3):387-401. doi: 10.3390/neurolint13030038
2. Roohafza H., Pourmoghaddas Z., Saneian H., Gholamrezaei A. Citalopram for pediatric functional abdominal pain: a randomized, placebo-controlled trial. Neurogastroenterol Motil. 2014;26(11):1642- 1650. doi: 10.1111/nmo.12444
3. Cooper T.E., Heathcote L.C., Clinch J., et al. Antidepressants for chronic non-cancer pain in children and adolescents. Cochrane Database Syst Rev. 2017;8(8):CD012535. doi: 10.1002/14651858.CD012535.pub2
4. Banerjee S., Butcher R. Pharmacological interventions for chronic pain in pediatric patients: A review of Guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; May 5, 2020.
5. Shnayder N.A., Kidyaeva A.V., Vaiman E.E., et al. Role of pharmacokinetics and pharmacogenetics of antidepressant-induced prolongation of the QT interval and Torsade de Pointes in patients with mental disorders. Personalized Psychiatry and Neurology. 2023;3(2):72-119. doi: 10.52667/2712-9179-2023-3-2- 72-119
6. Page M.J., Moher D., Bossuyt P.M., et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews BMJ 2021; 372:n160 doi: 10.1136/bmj.n160
7. Danilov D.S. Antidepressants are selective serotonin neuronal reuptake inhibitors: 40-year history. Neurology, Neuropsychiatry, Psychosomatics 2015, 1(7): 66-74. doi: 10.14412/2074-2711-2015-1-66-74. in Russian.
8. FDA: Drug Approvals and Databases. Available at: https://www.fda.gov/drugs/development-approval- process-drugs/drug-approvals-and-databases.
9. State register of drugs. Available at: https://grls.rosminzdrav.ru/Default.aspx. in Russian.
10. Gupta N., Gupta M. Off-label psychopharmacological interventions for autism spectrum disorders: strategic pathways for clinicians. CNS Spectr. 2024;29(1):10-25. doi: 10.1017/S1092852923002389.
11. Strawn J.R., Mills J.A., Poweleit E.A., Ramsey L.B., Croarkin P.E. Adverse effects of antidepressant medications and their management in children and adolescents. Pharmacotherapy. 2023;43(7):675-690. doi: 10.1002/phar.2767.
12. Baumel W.T., Mills J.A., Schroeder H.K., et al. Gastrointestinal symptoms in pediatric patients with anxiety disorders and their relationship to selective serotonin reuptake inhibitor treatment or placebo. Child Psychiatry Hum Dev. 2023. doi: 10.1007/s10578-023-01586-x.
13. Simon L.V., Keenaghan M. Serotonin Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 17, 2023.
14. Cubeddu L.X. Drug-induced inhibition and trafficking disruption of ion channels: pathogenesis of QT abnormalities and drug-induced fatal arrhythmias. Curr Cardiol Rev. 2016;12(2):141-154. doi: 10.2174/1573403x12666160301120217.
15. Ostroumova O.D., Goloborodova I.V. Drug-induced long QT interval: prevalence, risk factors, treatment and prevention. Consilium Medicum. 2019;21(3):62-67. doi: 10.26442/20751753.2019.5.190415. in Russian.
16. Wang G.K., Mitchell J., Wang S.Y.. Block of persistent late Na+ currents by antidepressant sertraline and paroxetine. J Membr Biol. 2008;222(2):79-90. doi: 10.1007/s00232-008-9103-y.
17. Cubeddu L.X. Iatrogenic QT abnormalities and fatal arrhythmias: Mechanisms and clinical significance. Curr Cardiol Rev. 2009;5(3):166-176. doi: 10.2174/157340309788970397.
18. Otsuka Y. Paroxetine-induced QTc prolongation. J Gen Fam Med. 2017;18(6):442-445. doi: 10.1002/ jgf2.137.
19. Yamazaki-Hashimoto Y., Nakamura Y., Ohara H., et al. Fluvoxamine by itself has potential to directly induce long QT syndrome at supra-therapeutic concentrations. J Toxicol Sci. 2015;40(1):33-42. doi: 10.2131/jts.40.33.
20. Wilde A.A., Roden D.M. Predicting the long-QT genotype from clinical data: from sense to science. Circulation. 2000;102(23):2796-2798. doi: 10.1161/01.cir.102.23.2796.
21. Wallace E., Howard L., Liu M., et al. Long QT syndrome: Genetics and future perspective. Pediatr Cardiol. 2019;40(7):1419-1430. doi: 10.1007/s00246-019-02151-x
22. Nesterets A.M., Maksimov V.N. Molecular genetic markers of QT interval duration and sudden cardiac death: literature review. Bulletin of Siberian Medicine. 2022;21(1):133-143. doi: 10.20538/1682-0363-2022-1-133-143. in Russian.
23. Okayasu H., Ozeki Y., Fujii K., et al. Investigation of the proarrhythmic effects of antidepressants according to QT Interval, QT dispersion and T wave peak-to-end interval in the clinical setting. Psychiatry Investig. 2019;16(2):159-166. doi: 10.30773/pi.2018.12.11.
24. Schwartz P.J., Ackerman M.J., George A.L.Jr., Wilde A.A.M. Impact of genetics on the clinical management of channel-opathies. J. Am. Coll. Cardiol. 2013;62(3):169-180. doi: 10.1016/j.jacc.2013.04.044.
25. Vaiman E.E., Shnayder N.A., Zhuravlev N.M., et al. Genetic biomarkers of antipsychotic-induced prolongation of the QT interval in patients with schizophrenia. Int. J. Mol. Sci. 2022, 23, 15786. doi: 10.3390/ijms232415786.
26. Maljuric N.M., Noordam R., Aarts N., et al. Use of selective serotonin re-uptake inhibitors and the heart rate corrected QT interval in a real-life setting: the population-based Rotterdam Study. Br J Clin Pharmacol. 2015;80(4):698-705. doi: 10.1111/bcp.12681.
27. Nosè M., Barbui C. Do antidepressants prolong the QT interval?. Epidemiol Psychiatr Sci. 2014;23(1):19- 20. doi: 10.1017/S204579601300070X.
28. Ojero-Senard A., Benevent J., Bondon-Guitton E., et al. A comparative study of QT prolongation with serotonin reuptake inhibitors. Psychopharmacology (Berl). 2017;234(20):3075-3081. doi: 10.1007/s00213- 017-4685-7.
29. Van Haelst I.M., van Klei W.A., Doodeman H.J., et al. QT interval prolongation in users of selective serotonin reuptake inhibitors in an elderly surgical population: a cross-sectional study. J Clin Psychiatry. 2014;75(1):15-21. doi: 10.4088/JCP.13m08397.
30. Funk K.A., Bostwick J.R. A comparison of the risk of QT prolongation among SSRIs. Ann Pharmacother. 2013;47(10):1330-1341. doi: 10.1177/1060028013501994.
31. Iribarren C., Round A.D., Peng J.A., et al. Validation of a population-based method to assess drug- induced alterations in the QT interval: a self-controlled crossover study. Pharmacoepidemiol Drug Saf. 2013;22(11):1222-1232. doi: 10.1002/pds.3479.
32. Elsayed M., Abdel-Kahaar E., Gahr M., et al. Arrhythmias related to antipsychotics and antidepressants: an analysis of the summaries of product characteristics of original products approved in Germany. Eur J Clin Pharmacol. 2021;77(5):767-775. doi: 10.1007/s00228-020-03049-x.
33. Abbas R., Riley S., LaBadie R.R., et al. A Thorough QT Study to Evaluate the Effects of a Supratherapeutic Dose of Sertraline on Cardiac Repolarization in Healthy Subjects. Clin Pharmacol Drug Dev. 2020;9(3):307- 320. doi: 10.1002/cpdd.749.
34. Aronow W.S., Shamliyan T.A.. Effects of antidepressants on QT interval in people with mental disorders. Arch Med Sci. 2020;16(4):727-741. doi: 10.5114/aoms.2019.86928.
35. Campleman, S. L., Brent, J., Pizon, A. F., et al. Drug-specific risk of severe QT prolongation following acute drug overdose. Clinical Toxicology. 2020. 58(12), 1326–1334. doi: 10.1080/15563650.2020.1746330.
36. Clinical psychopharmacogenetics. Ed by Nasyrova RF, Neznanov NG. Saint-Petersburg: DEAN; 2020. in Russian.
37. Shnayder N.A., Khasanova A.K., Nasyrova R.F. First phase of antipsychotic metabolism in the liver: the role of oxidation. Pharmacogenetics and pharmacogenomics. 2022;(1):15–30. doi: 10.37489/2588-0527-2022-1-15-30. in Russian.
38. Ryan K., Benz P., Zosel A., et al. QTc Prolongation in poison center exposures to CredibleMeds list of substances with "Known Risk of Torsades de Pointes". Cardiovasc Toxicol. 2022;22(9):866-877. doi: 10.1007/s12012-022-09764-4.
39. Drye L.T., Spragg D., Devanand D.P., et al. Changes in QTc interval in the citalopram for agitation in Alzheimer's disease (CitAD) randomized trial. PLoS One. 2014;9(6):e98426. doi: 10.1371/journal.pone.0098426.
40. Malin D.I., Ryvkin P.V., Bulatova D.R. QT prolongation syndrome with Antipsychotic and Antidepressant Drugs. Current Therapy of Mental Disorders. 2023;(2):48-56. doi: 10.21265/PSYPH.2023.69.57.006 (In Russ.).
41. Straley C.M., Sochacki M., Reed E., et al. Comparison of the effect of citalopram, bupropion, sertraline, and tricyclic antidepressants on QTc: A cross-sectional study. J Affect Disord. 2022; 296:476-484. doi: 10.1016/j.jad.2021.08.149.
Review
For citations:
Shnayder N.A., Makarov E.A., Kidyaeva A.V., Grechkina V.V., Petrova M.M., Nasyrova R.F. SELECTIVE SEROTONIN REUPTAKE INHIBITORS: A SAFETY ISSUE (SYSTEMATIC REVIEW). Transbaikalian Medical Bulletin. 2024;(4):133-149. (In Russ.) https://doi.org/10.52485/19986173_2024_4_133
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