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Celexa Heart, Cognitive Risks in Alzheimer’s Treatment

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February 27, 2014 — Celexa (citalopram) has been associated with an increased risk of heart problems and cognitive decline when it is prescribed to elderly patients with dementia, according to a study published February 19 in the Journal of the American Medical Association.

The conclusions were based on data from 189 patients with Alzheimer’s disease who were randomly assigned to receive Celexa or a placebo. Patients took Celexa for 9 weeks between August 2009 and January 2013.

At 30-mg per day dosage, Celexa was shown to significantly reduce caregiver distress and patient agitation. The use of antidepressants as sedatives in nursing homes is a widespread and controversial practice, with many now calling it a form of abuse.

Given the cognitive and cardiovascular risks, Dr. Anton Persteinsson, the author of the study, recommended that patients with Alzheimer’s should be limited to doses below 20-mg per day, and clinicians should be “judicious” when writing prescriptions.

This is not the first time Celexa has been linked to heart risks, but it raises particular concern for Alzheimer’s patients. In August 2011, the FDA required drug-makers to add Safety Warnings for cardiovascular events at doses above 40-mg per day.

Last year, the British Medical Journal published a study showing a dose-dependent relationship between Celexa and QT interval prolongation (the recovery time between heartbeats). The disorder can lead to severe irregular heart rhythm, ventricular tachycardia, Torsades de Pointes, and death.

 

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