Psychopharmacology: SSRI associated with QT prolongation: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: SSRI associated with QT prolongation

Sample item

A 68-year-old with depression is to start an SSRI, but she has a long QT interval on her ECG. Which SSRI carries a dose-dependent warning for QT prolongation and should be avoided?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Citalopram

Citalopram causes dose-dependent QT prolongation, and regulators limit its maximum dose, with a lower limit in people over 60. Sertraline is the preferred SSRI in cardiac disease.

Option by option

  • A. Paroxetine

    Paroxetine is not noted for QT prolongation.

  • B. Sertraline

    Sertraline has minimal QT effect and is preferred in cardiac disease.

  • C. Citalopram (correct)

    Correct. Citalopram has a recognised dose-related QT warning.

  • D. Fluvoxamine

    Fluvoxamine is not known for QT prolongation, though it has CYP interactions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Citalopram. Citalopram causes dose-dependent QT prolongation, and regulators limit its maximum dose, with a lower limit in people over 60.

Why is "Paroxetine" not the answer?

Paroxetine is not noted for QT prolongation.

Why is "Sertraline" not the answer?

Sertraline has minimal QT effect and is preferred in cardiac disease.

Why is "Fluvoxamine" not the answer?

Fluvoxamine is not known for QT prolongation, though it has CYP interactions.

What concept does this question test?

It tests Psychopharmacology: SSRI associated with QT prolongation in Psychiatry. Sertraline is the preferred SSRI in cardiac disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: SSRI associated with QT prolongation?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.