Citalopram & AF ?

Hello

My 93 year old father-in-law has just been prescribed the anti-depressant Citalopram 20mg/day. He also has AF. It says on the web to beware of this drug if you have a heart problems and particularly refers to Torsade de Pointes, so maybe it's just that condition which matters, and he does not have Torsade de Pointes as far as I know.

It also states that 20mg is the maximum recommended dose for people over 65.

I was just wondering if anyone else has taken this whilst they have AF and how they got on?

He's only just started but seems very tired which one of the listed side-effects which apparently should wear off after a week or two.

Also, none his family, including his wife (an ex-nurse) think he is depressed! But that's another matter I suppose.

Thank you

Koll

[Luludean]

They put me on it too, they mis/thought my AF was anxiety. It stopped me eating , horrible. It is used also to stop binge eating and drinking I think GP s prescribe it far too often.

[Hidden]

I believe Sertraline is an SSRI recommended if you have cardiac problems. Generally SSRIs are pretty safe, certainly a lot safer than the old tricyclic antidepressants.

I hadn't heard about SSRIs and Torsade but I do know that some of the Meds for rhythm control in AF can cause Torsade so they are often started in hospital with ECG monitoring.

[cassie46]

Hi Koll

I was on Citalpram last year when stressed out when my father was ill and then died. I was only on 10 mg and it did help but I was only on it for about 4 months. Not a fan of anti depressants, It did take a few weeks to kick in but no real side effects. Is your father-in-law suffering from anxiety rather than depression! Maybe a lower dose would have been better then increase if necessary.

Cassie

[Hidden in reply to cassie46]

He's in an old people's homes, a good one, but it's still not like being at home So he's naturally not too happy about it even though he realises it's his only and best option.

Is it anxiety or depression, I'd doubt it's depression unless you call not being completely happy with your predicament depression? He and I are quite similar and I would call it anxiety.

Re the dose, whether it's anxiety or depression, who knows, but what we all agree with is that it is not very bad. So why put him on the maximum dose for someone over 65? Especially as he's 93! I would have thought that the 10mg dose would be better, or least worst.

Thanks for your reply.

Koll 🙂

[CDreamer in reply to Hidden]

If he has full competence he does have the right to refuse any treatment.

It’s a horrible position to be in and I think I would be anxious in a nursing home these days.

I wonder if you and your family could help him to question the logic or prescribing and the longer term plan.

[Bagrat]

When I was working in a setting where people had life limiting illnesses citalopram was popular with medics as it is comparatively fast acting. Perhaps ask if plan is to reduce once it has caused a positive response??

[Hidden in reply to Bagrat]

Thanks Bagrat, I'm going in today so I'll ask the nurse, see what the plan is.

[AndyDuk]

I've been on it for years, as it stops the anxiety that comes with an AF attack. For me, its helped but I am a lot younger than your father.

[Hidden in reply to AndyDuk]

Thanks Andy. Can you remember whether you got any side effects and how long they took to clear up? If they did! He's gone sleepy at the moment.

[cassie46 in reply to Hidden]

Hi Koll

Cassie again - My dad died last year in August and was in a care home for the last seven months. He eventually made the decision himself that he could not cope at home any longer even with carer's in 3 times a day and family help. Your father-in-law sounds to be in the same frame of mind that my dad was, a bit lost, missing home ect. It must be a huge step to go from home to a care/nursing home knowing that you will never be going home again. There is not a lot you can do at the moment other than be there for him and help him settle in.

The care home that my dad was in was a lovely place, staff were wonderful, lots to do and food was very good. My dad was a very private person (ex policeman) and had to be pushed into mixing at the home. He did for a while then decided to stay in his room. He often used to say he wish he had a on/off switch on him, he had had a long and good life and he was happy to go. Sadly he did give up when his eyesight, hearing and mobility deteriorated. What I am trying to say is that it must be a very hard for someone in this position, fearfull even. Some folks do well in care homes and are very happy, some do not adjust and of course it depends on your health problems as well.

I hope your father-in-law settles in and is happy. All you can do is be there for him whatever happens.

Cassie

[Hidden in reply to cassie46]

That's an excellent summary Cassie. Sorry about your dad.

My mom did well in a care home, she enjoyed it as she had constant company and things going on. She found being at home boring because people were out a lot.

My dad would have hated being in a care home. I would probably like it as long as I had Sky Sports. My my father-in-law (ex-military) is fairly private. But he's doing OK.We're all different.

As you say all we can do is see him as much as possible.

Koll

[AndyDuk in reply to Hidden]

Well it took the normal 4-6 weeks to kick in, and I did feel strange as with any anti-depressent and it did suppress my sex drive .. I hope that's not an issue for your father in law at 93 ! If it is fair play to him !!!!!! Once they started working I lost all the anxiety with an AF attack which helps you so much ! I see it as a positive now ..

[Hidden in reply to AndyDuk]

Thanks Andy.