5 doctors weighed in:

I take 50 mg seroquel (quetiapine) and 25 mg escitaloprom, what is my risk of heart problems? Is this a total contraindication? should i do ecg? blood test?

5 doctors weighed in
Dr. Dia Arpon
Psychiatry
1 doctor agrees

In brief: Yes.

Escitalopram at 25mg is a high dose.
High doses of serotonin retake inhibitors combined with non-steroidal anti-inflammatory meds like asprin, Motrin can lead to stroke. If you notice easy bruising let your doc know. Furthermore seroquel (quetiapine) can cause prolongation of the qt syndrome in the heart for people who are prone to it. Generally the combo is safe but I would get an ekg to be safe.

In brief: Yes.

Escitalopram at 25mg is a high dose.
High doses of serotonin retake inhibitors combined with non-steroidal anti-inflammatory meds like asprin, Motrin can lead to stroke. If you notice easy bruising let your doc know. Furthermore seroquel (quetiapine) can cause prolongation of the qt syndrome in the heart for people who are prone to it. Generally the combo is safe but I would get an ekg to be safe.
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1 comment
Dr. David Lipkin
Dr Arpon is correct. I overlooked the fact that escitalopram is a high dose. I agree that you should have an ECG 2 days after you start the combination.
Dr. David Lipkin
Internal Medicine
1 doctor agrees

In brief: See below

Escitalopram and Seroquel (quetiapine) can each increase QTc interval.
When combined the risk of QTc prolongation increases further. The combination is not a total contraindication unless you have a history of one of the following: bradycardia, CHF,congenital QT prolongation, hypokalemia, low magnesium, family history of long QT--blackouts or sudden death. If non of the above an ECG isn't mandatory.*Comments

In brief: See below

Escitalopram and Seroquel (quetiapine) can each increase QTc interval.
When combined the risk of QTc prolongation increases further. The combination is not a total contraindication unless you have a history of one of the following: bradycardia, CHF,congenital QT prolongation, hypokalemia, low magnesium, family history of long QT--blackouts or sudden death. If non of the above an ECG isn't mandatory.*Comments
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3 comments
Dr. David Lipkin
A PROLONGED QTC INTERVAL MAY NOT LEAD TO TORSADES VERY OFTEN, OR EVER, in some people. The risk of TdP starts to grow when long QT is combined with other risk factors: history of syncope, lightheadedness, dizziness, palpitations or transient breathlessness or the risk factors mentioned in answer. (If no risk factors but worried>ask for ECG). See: http://bit.ly/1Jfg04J
Dr. David Lipkin
The risk of TdP (torsades de pointes: polymorphic VT that can turn into Ventricular Fibrillation) increases as the dosages of the medications involved increases. Additional risk factors:"stimulant" conditions such as exercise, emotion, or use of drugs like dopamine, epinephrine or even albuterol. females, particularly between menarche and menopause, appear to be at greater risk than males
Dr. Saptarshi Bandyopadhyay
Internal Medicine - Hospital-based practice

In brief: Low immediate risk

Ur Seroquel & Lexapro dose r both on the low side, so I doubt u'll experience any problems short-term. There r rare case reports of QT prolongation, a type of EKG abnormality, from Seroquel, but w/ higher doses.
Many pts take Seroquel & Lexapro together w/o problems. However, long-term, Seroquel can cause diabetes & metabolic risk 4 heart disease. So, consider alternatives like Geodon (ziprasidone) in abt 1 yr.

In brief: Low immediate risk

Ur Seroquel & Lexapro dose r both on the low side, so I doubt u'll experience any problems short-term. There r rare case reports of QT prolongation, a type of EKG abnormality, from Seroquel, but w/ higher doses.
Many pts take Seroquel & Lexapro together w/o problems. However, long-term, Seroquel can cause diabetes & metabolic risk 4 heart disease. So, consider alternatives like Geodon (ziprasidone) in abt 1 yr.
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