Lexapro or Prozac - what works better for arrhythmia?

[Annie2609]

I was wondering if anyone here had an experience with either Lexapro or Prozac working for their arrhythmia? I was on Lexapro for quite a few years, but didn't have the irregular heartbeats at that time. Then I decided to stop the Lexapro as I was gaining too much weight. After 2 months from stopping the medication, in December last year, I started having PAC's and PVCs on a daily basis. I am now taking Bisoprolol, and the Psychiatrist suggested trying Prozac as its better in regards to the weight gain. I started Prozac 10 days ago, and I am trying to get past the first few weeks with full blown side-effects (dizziness, insomnia, anxiety). At the end of the day, if I can get rid of the irregular heart beats, I will stick with the Prozac with all the bad side effects. But I would like to know about your experience.

[CDreamer]

Hi Annie - sorry you are having such a struggle.

I am confused as to a few things you describe in your post:-

I am wondering why a Psychiatrist is prescribing for arrythmia?

DId anxiety precede the arrythmias?

Arrythmias do tend to cause anxiety and sometimes it’s really difficult to know which came first but most people with arrythmias have anxiety to some level but cope very well without drugs such as Prozac using breathing techniques, relaxation, mindfulness, meditation etc. I think we may be able to help more if we had a little more information:-

Have you been assessed by a cardiologist/Electrophysiologist?

Is it thought your arrythmias are purely anxiety induced and if so, who said so?

Are you taking both Bisoprolol and Prozac?

Bisoprolol is a drug that many struggle with because of side effects but it is the usually the first drug prescribed for both chronic anxiety as it is an adrenaline/beta blocker but can also be difficult to withdraw from and withdrawal has been associated with symptoms you describe by several posters on this forum.

What dose of Bisoprolol were/are you on? Over how long a period did you reduce/stop?

Prozac, as far as I am aware, would not be a drug prescribed for arrythmias.

All drugs have affects - some unfortunately cause worse symptoms than the dis-ease.

Best wishes CD

[Annie2609 in reply to CDreamer]

Thank you for your reply CDreamer . I am currently taking 10 mg of Bisoprolol but that doesn't help so much with the palpitations. My cardiologist sent me to the psychiatrist she is working with as I was taking before antidepressants and she thought I was doing much better on them. The type of arrhythmia I have is irregular hearbeats which she calls PAC and PVCs. She said they are harmless and mostly caused by anxiety or hormonal changes... however for me they are quite debilitating as they affect my daily activities. Hope now my question is more clear, thank you so much for your time..

[Hidden]

I asked my EP that question a few yr ago and he said no issue with any of the antidepressants. When you read the fine print on most of the meds, you will read about them potentially causing ekg changes. My EP is a guy with great credentials and is professor at a medical school here in the US, So Im trusting his advice and ignoring fine print mostly liability warnings from the drug co. A side note, Im pretty much an antidrug person but have not had any a fib since on my antidepressant over 2 yr ago.... Ive made several life style changes but think my antidepressant has helped me also.

[Annie2609 in reply to Hidden]

Thank you Hidden that's what I understood as well. They want me to do an EKG every 3 months to make sure there are no changes. I also hate taking meds but realized without a constant treatment my symptoms are all over the place and simply cannot cope with the related anxiety. Which antidepressant you ended up on?

[Hidden in reply to Annie2609]

Im on sertraline which helps depression and anxiety

[Redders in reply to Hidden]

What strength sertraline are you on Hoski ? I’m on 50mg one a day which is working to point but wondered if a higher dose would be better.

[Hidden in reply to Redders]

I was on 50 mg and just increased to 75mg. My doc said 50 mg is a lower dose and he is ok with me going up to 100 mg if I want to. So Im trying 75mg for now and see how it goes

[T8746 in reply to Hidden]

I actually think that my antidepressant has helped to eliminate my afib.

It is complicated, but I had very quick improvement when I started mine.

I also read that serotonin depletion can cause arrhythmias.

[Palpman]

So, what you are saying is that you were on antidepressants BEFORE the arrhythmia started.

This brings me to believe that they actually caused the arrhythmia. They are certainly not used to arrest arrhythmias.

All antidepressants are known to cause a prolongation in the action of the ventricles and can be seen by the lengh of the QT interval on the ECG.

If this depolarization and repolarization of the ventricles is extended it may cause Torsades de Pointes type of arrhythmia that is not good to have. This is rare and typically happens when the cQT is longer than 500 ms.

Above 460 ms it can cause other benign arrhythmias.

If you are on an antiarrhythmic drug such as Flecainide and take antidepressants such as Prozac, Fluoxetine, Sertraline etc then you will be more susceptible for Long QT Syndrome (LQTS) that causes the above arrhythmias as both lengthen the QT interval.

This is the reason you must be monitored for LQTS and long P wave and QRS on a monthly basis.

The combination of the 2 drugs can also mimic Incomplete Left BB Block or LBBB.

[Annie2609 in reply to Palpman]

Hi Palpman thank you for your reply. I was on antidepressants before, but the arrythmia started a few months after I stopped them. I was thinking the same and know there are some risks, but in my case i had been off the drug for 3 months. I also have some angina which was better controlled while I was tsking an antidepressant. Thats why the dr advised to go back on it. I just didn't want to go back to the same antidepressant as it was causing problems with weight gain. But I agree regardless of which antidepressant i use, i need to monitor my heart periodically.

[T8746]

I am taking Prozac now.

It was difficult to get used to at first, but it has really helped with my anxiety at this point.

It is quite a relief !!

Also, my afib is essentially gone.

I am not taking any anti arrhythmics -and I haven’t had an ablation.

I am trying to sort out what has led to my success, and I really think that the Prozac has helped.

I have done a lot of research, and I have read that serotonin depletion can cause arrhythmias.

I don’t know if that is what is responsible, but am pleased.

Please note however, that everyone is different, and what works for me may not work for others.

[Annie2609 in reply to T8746]

Thank you for your input T8746 . I also started Prozac a little less than 2 weeks ago, it gives me other side effects for now, but I'm hoping I can see some results soon. I know everyone is different, but I rely on people's feedback and Your feedback shows me that I should continue with this one.

[T8746]

I hope that it works well for you.

BTW, at one point I had read personal reviews of Prozac on “iodine.com”.

Some people did well, some did not. But my experience seems to be in the “did well” category.

I wish you the best.