Antidepressants with Af

[Bigomlet]

What’s the most suitable medication for anxiety that don’t affect or trigger your AF ???

[BobD Volunteer]

As we are not medically trained here that is a question best put to your doctor..

[TracyAdmin Partner in reply to BobD]

Good Morning, thank you BobD you are absolutely correct. We always advise to speak to your GP to discuss introduction of any new medication or supplements. They are the best to advise you based on your own personal medical history etc. Take care, Tracy

[Bigomlet]

My GP did prescribe me Amitriptyline, I read the first paragraph that said “Don’t take these tablets if you have heart rhythm condition” 🤷🏽‍♂️

[jeanjeannie50 in reply to Bigomlet]

A few people on this forum take a low dose of Amitriptyline with no problems. I'll give Kaz747 a shout and hopefully she can tell you more.

[Kaz747 in reply to jeanjeannie50]

Thanks Jean- I take 10 mg Amitriptyline at night which I was prescribed for nerve pain. It’s a very low dose and my doctors and pharmacist said it’s fine but I understand higher doses are used when it’s used as an antidepressant and that’s where the issue is.

[Hidden]

All medication for anxiety combined with depression has the potential to prolong the QT interval of the cardiac cycle, which can be problematic in af. Ideally QT should be checked before and at intervals during treatment.

[Hidden]

Magnesium used to be used for psych patients before the introduction of lithium. It got rid of my afib within hours which was nice. Excersise which exacerbates some peoples issues and helps others helps anxiety and depression as good as antidepressants so if it doesn't trigger you then that might help anxiety. Deep breathing excersises. Mindfulness meditation. Counselling. CBT. I find cold water on my arms and legs very calming effect afterwards although have to do deep breathing first or I over think it before hand...if I deep breath first I somehow find the ability to jump in have a warm shower and then blast my aems and legs and sometimes get to do my whole body...its a bit daunting but afterwards I feel really calm in a strong way.... I like to do walking with intermittent sprints when I excersise which I don't do enough but when I had bad anxiety I forced myself out and went for a short run ..because in anxiety you feel like running away from it all it helped to not sit there feeling trapped but actually to run away ...and its supposed to help complete the flight or fifth cycle ...rather than stay in should I run or fight and being paralysed you run and your body thinks OK that's good we've probably got away from the threat and so after the little runs it calms the body down. Like a wind up getting released of its pent up energy. I find my anxiety is usually because I feel trapped and stagnant... Can't act so for me running was a way of acting psychically. Also avoiding all stimulants. Like exciting TV shows and friends with drama all the time and phone calls late at night..arguents you might have in your own head with Donald trump about politics...all not good for you. I would have arguments with people in my head. Anxiety can become a habit like smoking where you get a dopamine reward for getting hyped up..once I read that i realised I was getting a hit from winding myself up and I just said OK not gonna reinforce that. It helped ke think of it as an addiction rather than a oersonality thing. Like my body was craving the hit so it would want me to think stressfully ..a bit like how sugar loving bacteria makes you crave sugar...once I thought of it that way I was able to deny myself the high from getting wound up. It took me a few months of adding a new habit ...from sorting out my sleep to eating well getting enough salt was a thing for me too hydration excersise and I've slipped back and forth over the years with it. But I know if I ever really get anxious go for a walk have a splash of cold water drink some soup or elecrolytes take a magnesium watch a very unexciting TV show like highway to heaven or Shirley temple or mork and Mindy...turn off my phone. Listen to music. And generally do something. Something physical whatever it is. Sometimes I move furniture around or potter in the garden or dance to old tunes...anything to get excess energy out and away and bring the cycle to a full revolution. I don't always remember to do these things but when I do remember I feel I'm getting sonewhere with my health..I just ament great at being consistent with it all yet.

[Pigleywigley in reply to Hidden]

As a hypnotherapist & stress management consultant couldn’t have put it better! Great answer

[Hidden in reply to Pigleywigley]

Oh good! Thanks pigelywigely that is the cutest name on the planet. I may have to call my next child that. And it might be a baby pig child ...or a cat child...I'm glad I at least know what I should be doing even if I don't always do what I know is right. I have all the pieces of the puzzle but I haven't really built them into a solid base yet. Thats mt next job. Really give priority to those things. Especially as I have a new workload heading my way which will topple me if I don't have a good base. Thanks pigleywigely. Gaaah too cute!

[Pigleywigley in reply to Hidden]

Pigley wigley in respect of my white & spotty bellied dogs 🐶 I call them pigley wigleys. Plan for your busy time ahead & agenda in your ‘you’ time using your pieces of that jigsaw. Sleep, exercise, good nutrition & done good old slow breathing & meditation!

[Hidden in reply to Pigleywigley]

Yes today I breathed and stretched rather perfunctorily and then did all my supplements first before anything. and went for a walk.. All very much token efforts but I felt really good that I had ticked them off the list before everything else. I'll try to keep that up for a week if I can those four things every day for a wekk however token or short it will do more for me than all the organising apps I've ever downloaded lol! Thanks so much for the encouraging words.

[Pigleywigley in reply to Hidden]

Any time you need my help just shout up 😊

[Bigomlet in reply to Pigleywigley]

Thank you

[Palpman]

Do not confuse anxiety with depression as they are different and are treated differently.

Antidepressants taken with Flecainide or other antiarrhythmic drugs increases the QT interval. This is known as drug induced LQTS.

Antidepressants taken without antiarrhythmic drugs are fine.

Anti anxiety drugs can be taken with Flecainide as they don't increase the QT.

Many GPs do not know this as cardiology is not their strong point.

[Kingst in reply to Palpman]

I have to strongly disagree with your statement that antidepressants "taken without antiarrhythmic drugs are fine". Speaking from personal experience, and after researching and finding documented evidence as reported in such places as PubMed and online forums such as "Surviving Antidepressants", there is ample proof that whole classes of antidepressants have been implicated in arrhythmias, including AFIB. This symptom usually presents itself when one withdraws from the drug, especially if they have been on the drug for a long time. I was on Wellbutrin for years, without any heart issues, but when I withdrew from it slowly as recommended, within 2 weeks I was enduring a nightmare of skipped beats, heart pounding and "fluttering". This went on for hours during the day and would keep me awake all night. I was shortly thereafter diagnosed with AFIB. Most psychiatrists are either uninformed or resistant to the evidence of problems with these very powerful drugs, so its wise to seek out highly trained medical help in deciding on antidepressant medication.

[Palpman in reply to Kingst]

I was particularly speaking about drugs that can cause QT elongation. Nothing else.

[Pigleywigley]

Hi bigomlet! Anxiety is a really tricky situation for us AFibbers, because the physical symptoms of AFIb, fast heart rate, lightheadedness, breathing changes, pulsing neck, throat feels weird (yes everyone different) also mirror the anxiety response. Basically when our pre frontal cortex feels uncertain it shuts down stopping us rationally think, & flight, fright, freeze response is triggered. Some lovely examples above but another good technique is grounding a good article:

counselling-directory.org.u...

I am a trained hypnotherapist if you need my help direct message me. Happy to help fellow AFibbers.

[Bigomlet]

Some great responses, thank you all 🙏🏼

[secondtry]

The best 'medication' without side effects are lifestyle changes. Start to slowly remove all that stresses you including those sub-conscious issues. If you can't change one or more, change yourself. Personally, I avoid TV crime dramas and do an hour before bed of yoga, mindfullness & prayer to ensure a relaxing sleep, which of course reduces anxiety a few more notches. Good luck.

[Bigomlet in reply to secondtry]

I think I’ve had a bit of mild social anxiety for years, where certain social events that I was attending I’d worry about who was gonna be there, who would I talk to etc. But it’s gone a lot worse in the last few weeks, waking up every hour, worrying and over thinking about everything now.Me and the Mrs have been invited to a Birthday party in May and already I’m trying to think how to get out of going.

It’s not nice at all

[secondtry in reply to Bigomlet]

Sorry to hear that but just as the mind can cause us ill health I believe it can also heal. So I would do ALL of the things you feel help e.g. find a place in Nature that you enjoy and visit it daily if poss.

[Redders]

I take sertraline 50mg daily but could this be the reason I’m back in AF ??

[Karendeena in reply to Redders]

Hi Redders, possibly, happened to me, off them now but early days so struggling a bit with withdrawal symptoms

[Redders in reply to Karendeena]

How are you getting off them karendeena ?

[Karendeena in reply to Redders]

Hi Redder, took advice from doctor.....Cut the 50mg tablets in half and took half a tablet each day for a month. I then took half a tablet every other day for a month. Stopped them altogether just over a week ago. One thing I have noticed is that I don't feel so tired and I am up at 7.00am every morning. Still struggling with dreams though and feeling a bit anxious but determined as I know that they don't mix we with my other meds.

[Redders in reply to Karendeena]

I’ll try that starting tomorrow. You say you’re struggling with dreams, I dream a lot and they always make my AF so much worse. Hopefully the AF will subside a bit if I get off the sertraline. I’m also on apixaban and 1.25mg bisoprolol but my arrhythmia nurse wants me to go on Amiodarone but I’m not keen because of all the side effects.

[Karendeena in reply to Redders]

Hi Redders, my doctor told me that Sertraline is notorious for causing dreams in a lot of people, she also said it could be sometime until these subside so I am going to be patient.I am on apixaban too but bisoprolol didn't suit me so I am much better having been put on sotalol.

I have the utmost respect for my EP as he is top in his field of heart arrhythmias. When he took me off flecainide and bisoprolol he mentioned Amiodarone but said that it can have some nasty side effects one being the skin's tolerance of sunlight.

Good look and travel this journey with me 😊Keep me posted and I will update you on how I'm getting on

[Redders in reply to Karendeena]

Will do, thank you

[Sunbursts]

This is a strange point for me because .. after years of having a very stressful job in education, the menopause and then suffering from anxiety and depression to add to the mix. I went on 20mg of antidepressant for a good few years. I am not sure if the AF was a condition linked to taking the antidepressants, as I have often read that this can be case. I think that this is an area that needs further investigation, if so then people need to be aware. Having AF diagnosed is stressful and can create anxiety, so it’s all a bit of a vicious circle really. Luckily I have a very healthy heart, low blood pressure and keep relatively healthy, apart from the AF!!! I do yoga, use yoga breathing techniques and eat (or try) healthily. But that does not help when you are in the clasp of a bad period of depression and anxiety! Oh for a magic wand .....

[Hatten28]

I had an attack of depression / anxiety last year, was prescribed Diazepam, which I took very sparingly, and have some tablets left over in case I feel down again I take a very occasional half a tablet.What amazed me about your lifestyle as how you manage to be so controlled in sorting your life out, you try so many different aspects it makes me feel lazy and lethargic in comparison, wish I had a small bit of your determination to sort life out.

Good luck H

[Karendeena]

Hi Bigomlet, none unfortunately, I have been on Citalopram for years and a cardiologist changed me to Sertraline as he says it was 'safer. My EP has said come off them alltogether as they are notorious for causing palpitations/making them worse and mixed with some drugs can cause additional problems with QT intervals. I have weaned off them over the months but struggling with withdrawal symptoms

[babayaga]

Sorry didn't notice this sooner. In my case, I believe it was the Amytriyptiline that caused my AF, but it may just have been the higher dose, as Kaz says. I have already posted about that experience a while ago, so won't repeat it now. Currently taking Venlafaxine slow release, which unfortunately makes me very sleepy -- trying to see what else I could take.

[Hammerhead56]

Hi, I have wondered about Sertraline and AF, I simply went mad last year and ended up taking Sertraline from the beginning of September. On 3rd of October I was experiencing a rapid irregular heartbeat and was told I have AF which threw me completely although to be fair there are other factors involved ie very obese, high BP, excess drinking then, so cannot pinpoint whether or not it is a direct cause, also not helping was not being told 3 years ago I'd had an episode of AF, had I known it was , what it could lead to etc I would have done something about my lifestyle back then.