I am not new but I have not done a lot of posting so far.
I have been looking up posts about Afib and Antidepressants, because my doctor will only give me Mirtazapine and slow-release Venlafaxine, both of which make me very sleepy. The most recent posts I found were 5 months ago, the others 3 and 5 years ago, and most people were getting different antidepressants to mine.
I was just wondering if anyone had a more recent experience of taking antidepressants and Afib meds, which antidepressants they are taking, and how it has affected them.
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babayaga
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I have permanent AF and moderate heart failure (CRT-p now implanted). I take 30mg Amatriptilyne daily but supposedly for pain relief from PHN (post herpetic neuralgia) pain not as an actual antidepressant. It does nothing for the pain but does, I believe, help me to get a decent night’s sleep. The Cardiac GP I see was not happy about me taking it. I am not happy about it myself in some ways but having been an insomniac for most of my life, getting a proper nights sleep feels worth it as otherwise I can’t imagine how I would manage to sleep being in so much pain. I suppose it is possible that it is working as an antidepressant too as my quality of life has declined drastically since I had the shingles in January 2019.
I am so sorry to hear about your condition and glad that the amitryptiline is of some help (we all spell it different don't we --I can't remember where the Y is supposed to go). I am a bit surprised, because when I was on it it triggered my AF, and that could be why your cardiologist doesn't approve. But perhaps the implant makes it safer for you. Anyway I wish you all the best.
When are you taking Mirtazapine ? I take it last thing at night (as recommended on the label) and it gives me a good nights sleep but does not make me feel sleepy the next day.
I take it at night -- daren't take it during the day. But the Venlafaxine also causes sleepiness -- I know a few people who are fed up with using it for that reason.
There are many different families of antidepressants on the market, and within those - many kinds. That's good, because we vary in widely as to efficacy and how we tolerate them. It took me years to find one that worked - and that was amitriptyline. Thankfully I was off of it at the time of my AF diagnosis. and my cardio does not want me on it if I can help it. So I'm managing on a different one. There is a wide selection so why not try something else? Here's help from Harvard:
Hi Marcy, thanks for the link you sent. I am looking online to find out more about medication effects, and I will definitely look up Harvard.
But as regards trying something else....
I am 72, and I was diagnosed with depression age 18. I didn't take the tablets all that time, but after a breakdown when I was 28, I did. Over the years I have been prescribed TWELVE different antidepressants.
I am having some good psychotherapy now, and I hope I can reduce the amount I am taking, but after all that time on the stuff, it is unlikely that I can come off completely.
As for the ones mentioned in the posts, there aren't any that I haven't had. Citalopram was good, but it seemed to stop working after a couple of years. Sertraline didn't work that well. Escitalopram didn't work at all. And Fluoxetine caused a minor heart episode.
Amitriptyline was the best thing I ever had. But in 1994, three years after I started taking it, I began having minor heart episodes. I was tested -- wearing the box for 8 days, that sort of thing -- and no arrythmias came up, so I was told that I must be having panic attacks!
Even so, a few years later they took me off Amitriptyline and prescribed a whole series of other antidepressants, including the ones I mentioned.
In 2004, ten years after I had reported the heart problem, I was hospitalised with a paroxysmal AF episode -- and, finally, they believed me! I was given several heart medications and now I take Flecainide, Candesartan and Bisoprolol.
I was given slow release Venlafaxine and Mirtazapine, along with Pregabalin, 3 years ago, following another breakdown (how boring is that....). I was told that was all I would be allowed to have, and that the tiredness would go away. But it hasn't, and I have decided to research the other options -- that is the main reason why I wanted to know what people were taking.
I might try Citalopram or Sertraline again if I can get doctor's consent (or a second opinion? ), and I will look up whatever I have not taken to see what possibilities there are.
I've been on many of those you list but that was years before my AF diagnosis a year ago. Have they contributed in some way? I suppose it's possible.
I am taking a very low dose of Trazadone, an SSRI, for my sleep disorder. However, as I recently checked into it, I discovered it has a causal association with arrhythmias. Yikes! I didn't know that. I will have to talk to my cardio doc about that since he doesn't know I'm taking it.
The only one that I know has contributed is the Amitriptyline. The Fluoxetine gave me an episode, but I was off it after 2 weeks. The Venlafaxine I take now is slow release, so they may have thought that the regular type contributed. The impression I got from them was that everything else might contribute except the Mirtazapine. When I have looked online about the medication I will post something here about it.
I've heard of Tradozone but don't know about it -- is that generic name or brand name?
No, you got it right! My thanks was sincere. I was the one who was wrong 😧 and I try to be careful about spelling. Yep, a hassle. We're in it together!
Well I hope you get sorted. Sertraline certainly works for me but I am actually taking it for anxiety. You shouldn’t have to feel this way especially for so long. If you need a chat let me know.
I was communicating with all of you about this 10 months ago!!! Still taking Flecainide, Candesartan and Bisoprolol for the AF, and Venlafaxine slow release, Mirtazapine and Pregabalin for mental state. All that stuff.... The shrink said that if I could reduce the Ven dose I could perhaps switch to Sertraline. I have reduced it over several months, but around Christmas I felt really low. That could be about other things, like a second lockdown, and my dear cat being very ill -- I am worried that she may not survive it. But if it's the Ven reduction causing this, I will just have to live with it, until I can change to something else, because slow release Venlafaxine has terrible side effects that are making my life difficult.I do wish the medics would figure out what antidepressant fits with with what heart condition, and be more honest about the side effects.
It is of utmost importance to let your cardiologist know that you take anti depressant drugs such as Sertraline as it can cause LQTS especially if taken with Flecainide and some other anti arrhythmia drugs. You will need regular ECG's to check the QTc duration.
LQTS or Long QT Syndrome is the duration of the QT on an ECG. Normal QTc is less than 455ms but if longer it can precipitate a ventricular tachycardia. Cot deaths and sudden sports related cardiac arrests are thought to be the result of LQTS.
I cannot take any anti depressants as all NHS prescribed anti depressants lengthen QT to some degree. If taken together with Flecainide and similar drugs the QTc duration could in excess of 480ms.
My doctor searched for an anti depressant that I could take but found none. My QTc is 477ms.
On the ECG. The largest wave will be the ventricles contracting representing QRS complex with R as the peak.
The small wave just before the QRS complex will be the Atrials contracting called the P wave.
The small wave just after the QRS complex is called the T wave. This wave is not due to the physical contraction of the heart muscle as the P and QRS waves are. This is the heart's electrical system resetting back to normal for the next pulse cycle.
The distance from the start of the QRS wave or at the Q to the end of the T wave is known as the QT duration.
If this duration is too short then it may precipitate AFib.
If it is too long then it may precipitate the naughty ventricular tachycardia.
Most GPs are not aware of this. My GP did not and only because of my insistence for an ECG to test for this did she comply. She took me off Sertraline eventually.
Google "LQRS" and you will get a better insight than I can give you.
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