Why should doses greater than 40 mg of Citalopram be avoided?

The appropriate reason for avoiding doses greater than 40 mg of Citalopram relates specifically to the risk of QT prolongation and Torsades de Pointes. QT prolongation is a measure of delayed heart repolarization, which can lead to serious cardiac arrhythmias, including Torsades de Pointes, a potentially life-threatening condition. Citalopram, particularly at higher dosages, has been associated with this risk, which is further heightened in patients who may already have other predisposing factors such as existing heart conditions or concurrent use of other medications that also prolong the QT interval.

Monitoring and limiting the dosage to a maximum of 40 mg is a safety measure to help minimize these cardiovascular risks, ensuring that patients receive the therapeutic benefits of the medication while also reducing the potential for severe side effects associated with higher doses.