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Do all antidepressants cause QT prolongation--how good is the evidence?

Good quality data to support these conclusions are available for citalopram and escitalopram. For the remaining drugs, data are of poor quality, or have to be inferred from unusual circumstances (e.g. associated with very high blood levels after overdose, which may also involve ingestion of other drugs). Ideally, statements on QTc prolongation would be based on data generated in a Thorough QT study, which is methodologically demanding. 3 Alternatively, large simple trial designs can be used to evaluate cardiac safety of drugs. 4 Inference of QTc prolongation from in vitro HERG binding data may be less than ideal, as some drugs which are potent HERG inhibitors have no clinical cardiac safety signals, 5,6 or have negative Thorough QT data. 6