Trade Names for Sertraline and Escitalopram
Sertraline is marketed under the trade name Zoloft, and escitalopram is marketed under the trade names Lexapro and Cipralex. 1, 2
Specific Trade Names
Clinical Context with Hydroxychloroquine
When considering these antidepressants in a patient on hydroxychloroquine, sertraline is the preferred choice due to its lower risk of QTc prolongation compared to escitalopram. 1
Key Safety Considerations:
Sertraline has been studied extensively and demonstrates a lower risk of QTc prolongation compared to citalopram or escitalopram 1
Hydroxychloroquine itself causes mild QTc prolongation, though the prolongation is typically subclinical 3
Concurrent use of hydroxychloroquine and antidepressants did not further increase QTc intervals in a cohort of lupus patients, though individual patients may still develop clinically significant prolongation (QTc >500 milliseconds), particularly those with underlying cardiac conditions 3
Practical Recommendations:
Obtain baseline ECG before initiating either antidepressant in patients on hydroxychloroquine 3
Monitor with follow-up ECG after starting the antidepressant, especially in patients with pre-existing cardiac disease 3
Escitalopram and citalopram have lower potential for drug-drug interactions via CYP450 enzymes compared to other SSRIs, which may be advantageous in polypharmacy situations 1
Avoid combining with other QT-prolonging medications when possible 1