CriticalSSRI (selective serotonin reuptake inhibitor)×First-generation antipsychotics. Butyrophenone derivatives
Updated · Methodology
Mechanism
Haloperidol is a typical antipsychotic, and its own SmPC outright forbids giving it with QTc-prolonging drugs. The SSRI labels name it as their antipsychotic example. The citalopram SmPC lists ongoing treatment with any drug capable of prolonging the QT interval among its contraindications, with no exceptions.
Symptoms
QTc prolongation on ECG, palpitations, dizziness, syncope. The end point is polymorphic ventricular tachycardia of the torsade type progressing to ventricular fibrillation. The risk is higher with hypokalaemia, hypomagnesaemia, bradycardia, decompensated heart failure and in women.
Management
The pair sits in the citalopram SmPC contraindications, so the question is which drug stays, not how far to cut the dose. The ban stands on both sides, and parenteral haloperidol carries more risk than oral. If an antipsychotic is needed, the question is settled on that side, not by trimming the antidepressant dose.
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
- FDA: Haloperidol tablet (Ajanta Pharma USA Inc.) – Prescribing Information (2008)– ; DailyMed setid 31e33656-2f53-49e6-9816-261ea2e6961a
- AEMPS: Ficha técnica de Seropram 30 mg (citalopram) (2024)– AEMPS CIMA, nregistro 63564, revisión 01/2024, secciones 4.2, 4.3 y 4.4
- AEMPS: Ficha técnica de Haloperidol Esteve 10 mg (2020)– AEMPS CIMA, nregistro 58343, revisión 07/2020, secciones 4.3 y 4.4