CriticalSSRI (selective serotonin reuptake inhibitor)×Selective serotonin reuptake inhibitors (SSRIs)
Updated · Methodology
Mechanism
Escitalopram is the S-enantiomer of citalopram, the same molecule in purified form. Taking both stacks the dose of one substance, and with it the dose-dependent QT prolongation. The escitalopram SmPC contraindicates any QT-prolonging drug alongside it: the ban is written broadly, and the classes in brackets are examples.
Symptoms
QTc prolongation on ECG, palpitations, dizziness, syncope, with torsade at the far end. Serotonin syndrome is tracked separately: agitation, confusion, tremor, myoclonus, sweating, hyperthermia. Arrhythmia risk is higher with hypokalaemia, hypomagnesaemia and bradycardia.
Management
The pair sits in the escitalopram SmPC contraindications, so the question is which drug stays, not how far to cut the dose. This pair in a prescription list means an error rather than a regimen: usually the same drug has been written under two brand names. One is kept, and no washout is needed when switching between them, since the substance is the same.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- AEMPS: Ficha técnica de Cipralex 10 mg (escitalopram) (2026)– AEMPS CIMA, nregistro 65230, revisión 03/2026, secciones 4.3 y 4.5
- AEMPS: Ficha técnica de Seropram 30 mg (citalopram) (2024)– AEMPS CIMA, nregistro 63564, revisión 01/2024, secciones 4.2, 4.3 y 4.4