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AF Association
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I want to stop sotalol ... and use it as pip??

Hi guys ... l want to slowly stop taking sotalol but continue with my blood pressure meds. Something is making me feel very sad and depressed. I haven’t had an episode in almost one year. Have had two in total. However, l wonder if it is the sotalol that is helping? I find myself very tearful and difficult to get thrilled about planned trips, etc. l like being alone and feel very antisocial. My husband is in Europe at this time and l am supposed to join him soon. Flying from America to Europe alone frightens me. I was never this way before. Thank you! Here l am sitting out by the pool!! All alone!

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Here in UK Sotalol is not recommended for treatment of AF by our authorities so can't comment on any side effects. We can't advise on drug dosage either not being medically trained but all I will say is that any treatment for AF is only about improving QOL (quality of life) so if it is adveresly affecting this then one should discus with your medical team.

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Do you have any idea as to why it isn’t recommended?

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I understand that it can introduce some unwanted ventricular arrhythmias in some people. There are also plenty of better drugs. There are some special cases where an EP may prescribe it .

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Thank you Bob so very much! Perhaps that is why each time that l visit him .... every three months ... he gives me an ekg. The results are always perfect. I have so much to be thankful for ... l shouldn’t allow a little sadness to get me down ... it’s silly. Thanks again!

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Depression should never, ever be underestimated, it’s a serious illness with many causes and needs to be treated if your mood (not emotion) is low and depressed for more than a few weeks, without cause. Anxiety is often a symptom of depression.

May I suggest that a first point of call would be to look at nutrition and have your B12 & Vit D levels checked - for optimum levels! But a full blood work up may show something - from a nutritional point of view. Look for a qualified Nutritionist or Functional Medicine Doctor. Personally I would be very wary of taking anti- depressants - especially if you have AF as they can cause other heart arrythmias.

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Thank you !! I would never ever consider anti depressants ... not to worry! I will have my vitamin B and D levels checked! I just had a lipid panel taken and everything was perfect. I think that the sadness that l sometimes feel stems from anxiety over this afib. It terrifies me. Although it has only happened twice. Today l feel happy. Yesterday l was sad! My cat was ill and my mind told me that he was dying! I looked on line for symptoms of a dying cat! Today he’s fine! Crazy things like that happen to me. I was never that way before afib. Thank you for indulging me. You are so kind! Jan

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Janith,

At diagnosis 2 1/2 yr ago, my cardiologist here in USA put me on sotalol. I didnt tolerate it well, after many complaints and no changes... his reply was " just work thru it", I sought second opinion of an EP. He took me off Sotalol in a weaning off process and prescribed a rhythm drug( flecainide) and rate drug( metoprolol) to only be taken if I have a fib. Like you, I only had episodes every 6-11 months. This worked great til I had 2 back to back episodes in march so they both wanted me to take meds daily, which I have and tolerated flecainide much better. I am going off daily meds this week and giving as needed meds another try. I became very depressed in the beginning, dont know if it was the drugs, anxiety of a fib and unwanted life style changes. I did ask for antidepressant which I took for 2 yr. since then Ive learned to meditate, exercise, put a fib out of my mind, and get on with my life. I am way more fun to be around and I love life again but it has been a process. My first 12-18 mo with a fib was very anxiety ridden, the sky is falling type mentality. Hang in there. You will find your smile again if you keep looking!

By the way, I love your beautiful pic. Get on the plane and go have fun. My hubby made a huge difference in me learning to not give in. I wouldnt want to dance with the ugly a fib monster alone.

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You are wonderful! Thank you for making me feel oh so much better. My husband as well cheers me up but we have two properties in Europe and he is away there now ... he goes each year for three months and l join him mid way. We have paid for my ticket ... l will put on my brave face and off l go!!! I too exercise on a daily basis ... and take care with diet. I don’t want to take my kittie for such a long flight. Hence, the separation. Take care Hoski and again l thank you for your beautiful and helpful words. I send you a hug from afar. Jan 😘

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Let us know how everything goes

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Will do!

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You go girl! I use the app Calm for a guided Mindfulness meditation, it seems to be a very popular choice and options which starts right at the beginning for learners.

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Hoski,

I just want to say that was a beautiful response and posting. You are a gem. 🌸💕

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Thankyou so much! Just speaking from my heart( no pun intended!!!). I remember too vividly those dark days. There really is light at the end of the tunnel.

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Unfortunately anxiety is the travelling companion of AF - a fear of dying or of others dying is existential anxiety and can be helped and is incredibly common, especially with people who suffer arrythmias.

I gave a talk to our local AF support group in Jan - here is a link to the notes I posted on here.

healthunlocked.com/afassoci...

At the end there is a list compiled by the members of this forum as to what they found helped. Hope it is of use to you and please keep posting - you will find a lot of support, information and friends here.

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Oh, thank you so very much. Yes apparently we all have other things in common ... kindness, understanding, helpfulness, love ... what a fab group of people. We are so lucky to have found one another.

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I was prescribed Sotalol after an ablation for ventricular tachycardia (caused by looping due to extra node). Janitor, very similar experience including sleeping excessively. Rx is half 80 mg morning n night. Have been skipping or just tiny piece in morning. The second Rx warnings were more exhaustive. Think I'm going to stop Rx.

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Was that Wolfe Parkinson White syndrome?

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????

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It was the EP that did the ablation for SVT that gave me Rx for Sotalol 80 mg...half am n half pm. I was taking Buproprion for years ......recently stopped. Feeling alive again. Perhaps the two together had me blah and sleeping 15 hrs a day.

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I am in UK in England and am on Sotalol for treatment of AF prescribed by my cardiologist last December so I am not sure where your information comes from.

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Current (2018) Nice regulations for Sotalol for AF. Maybe this is more up to date than the 2014 guidelines quoted earlier. I take it to stop the attacks of irregular heartbeat. I have previously suffered from tachycardia (very fast regular beats) which was treated with bisoprolol which didn't stop the irregular beats. (in my understanding of EP explanation!)

bnf.nice.org.uk/drug/sotalo...

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Same here Cat. The cardiologist swapped my Bisoptolol for Sotalol as I was getting breakthrough AF. Mind you, I am still getting it with Sotalol so waiting to see what he suggests next when I go to see him.

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What's causing extra beats? I had an extra node causing mine. EP ablated so ? low dose Sotalol purpose.

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What is considered “low dose”?

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40 mg bid

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Thank you.

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Does Sotalol make you sleep hours more?

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The opposite is true. I have difficulty sleeping.

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Interesting! Rx label states "may cause dizziness". I try to skip AM dose. End up needing a nap and waking up 3 to 5 hrs later.

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Naps are healthy! I’m hyper. I wouldn’t know how to take a nap. I asked my cardiologist if sotalol causes insomnia ... he said that it makes most of his patients sleepy! Everything is opposite with my system seemingly.

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Is QOL reason true with SVT ablation as well?

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Many drugs can cause depression, beta blockers are on the list.

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I stopped Buproprion a few weeks ago. No difference except feeling more calm. This excessive sleeping started after ablation/sotalol. Possibly caused diverticulitis which then had me sleeping 20 hrs a day. At least when I'm awake I have more energy and brain fog is gone. How do you know if SVT returns? 99% of the time I never felt anything. FU with EP was strange. So asymptomatic except looping at length...only wearing monitor for weeks is fu.

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I don't think sotalol works that way, as a PIP. It's a beta blocker and needs to stay in your system. I take it twice a day.

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Do you have any issues with it? How long have you been taking it?

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What is PIP

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Pill in pocket. Only take it when you need it.

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I have been taking sotalol since January. I had to be admitted to the hospital and monitored for 36 hours when I started taking it because of potential issues and interactions. I take 120 mg 2x daily. It really seems to have worked in terms of quieting down my afib. By the time I had ablation 3 months ago my afib was pretty much gone. I still have some chest pain. I wonder sometimes if it is the sotalol.

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I never have chest pain ... l thought that ablation was supposed to stop afib? I would never consider such a procedure unless desperate. Perhaps you no longer need such a high dosage of sotalol? Thank you for the info. Greatly appreciated.

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I haven't had afib since the ablation. Just some palpitations every now and then. I would like to get off the sotalol. I am a big guy - 250 pounds - so the high dose made sense at first. I see the EP this week. Hopefully he will reduce some meds.

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Hopefully! My cardio loves over prescribing.

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I had cardioversion and take Xarelto. Has worked great for me. I had bad reaction with Eliquis.

Joyce

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Does the Rx make u tired?

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I have not had a problem with tiredness on sotalol.

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Need for Sotalol despite low dose confuses me as well. My tachycardia was caused by extra useless node which was ablated. Can an ablated node reopen? Is Sotalol meant to prevent same?

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I never had chest pain either. Just weak and feeling faint. Fake loop with blood going nowhere. That's why I'm confused 're Sotalol. Isn't ablated "fixed"? EP said I could have been born with that extra node.

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240 mg in 24 hrs? Any side effects?

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I am on Sotalol for af and know others that are.(all in UK)

Nice recommendations for sotatol in AF cases as follows

bnf.nice.org.uk/drug/sotalo...

I was started on it by EP in November and it seems to be doing the job. Prescription of sotalol seems to be continuing and I cannot find anything about it no longer being recommended . Do you have more information or a link Bob?

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nice.org.uk/guidance/cg180/...

Rate control

1.6.2 Offer either a standard beta‑blocker (that is, a beta‑blocker other than sotalol) or a rate‑limiting calcium‑channel blocker as initial monotherapy to people with atrial fibrillation who need drug treatment as part of a rate control strategy. Base the choice of drug on the person's symptoms, heart rate, comorbidities and preferences when considering drug treatment. [new 2014]

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Yes it may well be the case as BobD says, however, there are some of us in the uk & on this forum that it is prescribed for, who get along with it fine, & as he also points out any side effects if any at all are down to the individual .

Have you thought that perhaps your sadness & other issues could perhaps simply be because you were diagnosed & prescribed medication in the first place?

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Yes. I asked my cardio if l could take 40 once per day vs 40 morning and evening ... he said no! I told him about NICE ... he said ... “what do the Brits know about medicine!!” He is Indian!

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I take mine in the morning,on Electrophysiologists advice,and if I get a racing heart later in the day,can take another dose to settle it down. Cheeky Cardiologist! We know a fair bit about medicine here,not so much about charging fees for it lol!!! Xxx

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What is your morning dosage?

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2.5 mg,and can repeat if I need it..seems to be doing the job...fingers crossed!!

have a lovely time,hope you feel more settled? Xxx

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2.5 mg? Lowest dose here is 80 mg so I break in half 1/2 q 12 h

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Ouch.

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I had the same thing and I told the GP I wanted to stop it he said OK. My heart rate went up and so I went back in to A&E and they put me on verapamil but that made me feel awful to so I have now stopped that. I am awaiting an appointment at new cardiologist until then I am just taking my BP meds. Talk to your doc before you come off anything very important. Good luck x

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Thank you!

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Hello Janith

Cant comment on your medication but i am on a betablocker too and it took a lot of getting used to,and still feel at times I wish I didnt have to take it daily,as it still makes me lethargic and gloomy sometimes.

I have found that I regularly get bouts of anxiety and sadness at having this condition,think many of us do,especially perhaps those who have always been kinda confident,go getting people,who are now faced with a conditon which calls its own shots .I think looking atbthe strategies suggested by Cdreamer might help you feel more in control and with some weapons to use.I found her suggestions very helpful.

B12 and vit D are important too,as others have said,as well as eating as healthily as we can.

You go and enjoy your holiday with your man,sure kitty will be fine.My pets always seem to know if I am going away !

Let us know how you get on and enjoy!!

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Thank you!

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I agree. A Holiday is healthy in many ways.

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Let us know when you get there,and enjoy!! A change of scene can help a lot...We went on a trip recently and it did me good,just in England where I live but was really beneficial.....best wishes Janith x

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Thank you so much!

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I saw a holistic MD due to fatigue, weight loss etc. He basically revived my immune system( diverticulitis after ablation) and Sotalol. B 12, C, Ozone, Diatomaceous Earth (food grade).......Feeling better. Brain fog is rare now.

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P.S. My blood work came back perfect.....except B12 too high part of my holistic immune build up. Never knew it could be too high. Per research elevated B12 can cause cancer.

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I was prescribed sotalol in 1990 when pregnant with high blood pressure and occasional af(once every one or two years) I took it for 27 yrs until cardiologist suggested Carvidillo as I was now in permanent af. I was really happy with sotalol but Cardiologist says more modern drugs are more efficient

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I know ... my pharmacist said that it is a very old and established drug.

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I think likewise, I am off meds (I was on Amiodarone) waiting to clean the system for a new ablation, and since I have to wait like two months with no meds, if a I have an occasional episode I take 40mg of sotalol (on my own) and it stops within one or two hours,

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Super!

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I dare doing it because I can feel if I have arrythmia or not, when it starts and when it ends.

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