MajorClass III antiarrhythmic×Selective serotonin reuptake inhibitors (SSRIs)
Updated · Methodology
Mechanism
Sertraline at high doses (above 150 mg/day) moderately prolongs QT. Combined with dronedarone, risk of torsades de pointes rises, especially in older patients.
Symptoms
QT prolongation on ECG. Dizziness, syncope, palpitations. Severe cases: polymorphic ventricular tachycardia (torsades de pointes). Risk is higher with hypokalaemia and hypomagnesaemia.
Management
Avoid the combination with sertraline above 100 mg. At low doses (50–100 mg) with normal potassium and magnesium, the combination is acceptable with ECG monitoring at 2 weeks. Alternative antidepressants: mirtazapine or agomelatine.
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.
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Sources
- FDA: Multaq (dronedarone) prescribing information (2020)– ; DailyMed setid 7fa41601-7fb5-4155-8e50-2ae903f0d2d6
- AEMPS: Ficha técnica: Sertralina (nº registro 66057), sección 4.5 (2025)– AEMPS, CIMA, nº registro 66057, sección 4.5