Sertraline and Sotalol

[Stu13]

Apologies as I have already posted this on a previous thread, but I think other fellow AFibbers need to be aware of this.

I was recently put on a low does of Sertraline (an anti depressant) as a treatment for IBS, as had the most horrendous abdominal cramps that over the counter medications barely touched. Apparently it is now often used as the next line of treatment for IBS for those in genuine pain. GP warned me it could interact with the Sotalol I'm currently on and cause "some rhythm issues" so wanted to review after a month

Boy, didn't it just react! After about eight days I developed the most debilitating PVCs that knocked me for six. Ended up phoning 111 as was getting mild chest pains. They sent out a paramedic to check me over. ECG picked up the issue, but as I was technically in NSR he wasn't concerned but to call 999 if condition worsened. My GP advised me to come off it straight away, however it took another 5 days for the PVCs to ease. Even now I'm still getting episodes, but not as violent.

Of course this could be all coincidence, but an out of hours GP plus a pharmacist friend also confirmed that Sertraline was probably the likely culprit as it can cause irregular rhythms anyway as a recognised side effect and the Sotalol only exacerbated the situation.

Obviously as we all know on this forum we are all different in terms of how our hearts behave and the unpredictability they sometimes throw at us but I thought it would be useful to share my experience.

[Paulbounce]

Hi Stu.

A very interesting post for me. I am on both Sertraline (50mg) and Sotalol (80mg x 3 daily). I looked in to it and was aware it can increase (or decrease) HR. My cardio said I could knock it up to 75mg but I'm not going to chance it. So far I have had no ill effects (other than going to the loo more often). In fact I don't even know I have afib at the moment except for feeling a bit breathless at times.

As you say we are all different and it appears to have knocked you for six. It takes about a week to totally clear from your system so hopefully you'll find the side effects clearing up very soon.

Paul

[Tommyboy21 in reply to Paulbounce]

I just got started on it by GP then told to stop by cardiology as it cannot be used while I'm on dronedone.

[Stu13 in reply to Paulbounce]

Thanks for the good wishes, Paul. Definitely on the mend

[Hatten28]

have read your comments concerning sertraline and sotalol, I have been taking sotalol for about 18 years and approximately 3 months ago was advised to take 25 mg of sertraline,glad to say had no effect on me at all, so far!.

However my brother was advised to take 100 mg per day and is now very I’ll.

He has lost a lot of weight and felt nauseous constantly, and now waiting results from hospital tests, he looks and sounds dreadful, so thank you for the warning and hope it helps others taking this medication.

[Ewloe]

I’ve been on sertraline for about 3 months. My EP said it was the safest anti anxiety medication. For someone with my issues. I’m on bisoprolol riveroxaban and the other heart medications. After a heart attack I have PAF - but very infrequent, none sustained ventricular tachycardia and a bit of benign SVT. It does say any side effects are worse in the beginning. It’s had no effects on my heart rhythm issues but did affect my IBS and anxiety at first both of which now have settled down.

[Ppiman]

I had the most awful experiences with SSRI drugs about a decade ago and feel they are over-prescribed. Twitchiness, itching and insomnia were just a few of the side effects. They take a long time to start working and a long time to clear the system and some people suffer a lot on them.

Recent work has shown that we have no real idea how they work, either, I gather - that is, when they do, which seems to be well under 50% of the time.

Not for me.

Steve

[Palpman]

I was put on Sertraline 2 weeks ago and my palps started immediately.The palps were almost consistent day and night.

It was changed to Mirtazapine and the palps ceased the next day.

I've not had a single ectopic since.

[oscarfox49]

Hi, I've been on sotalol 80mg (half dose 2x a day) since 1995. Though once I got used to it, it worked well and it reduced my AF a lot. However I had a stroke in 2020 as I was not using a proper anticoagulant.

After the stroke I was on a cocktail of Fluoxetine and Oxazepam (benzodiazepine) for depression but neither affected my AF (though it has become permanent after the stroke) but I had a v difficult time for 18 months, just post stroke fatigue and so on.

drugs.com/drug-interactions...

I found this on interactions with Sertraline, though I have no personal experience of that drug. It is however another SSRI (seretonin uptake inhibitor) so I would have thought your doctor would be better in prescribing Fluoxetine as it does not have similar contraindications with Sotalol.

Fluoxetine is also given for eating disorders (like bulimia) but it might have a beneficial effect on your IBS,

Fluoxetine/Prozac may be old hat but it has a proven record of success with limited side effects. Coincidentally I just took my last frament of it after 18 months having weaned myself off it with no problems over the past 3 months.

See what your Doc thinks and good luck.

[Stu13]

Some really fascinating responses, confirming how different we all are with our tickers and their frustrating behaviour. Thankfully feeling much better. Due to see EP next week as PVCs have been an issue over last six months. Just glad they’ve calmed down for now.

[adventures]

Sorry to hear you're having a bad time on those drugs. But we all know side effects come with ... and it's a nightmare if taking different drugs, which one is the culprit, luckily or unluckily you found out?! I have PAF and take Edoxaban anti-blood clotting plus Sotalon 40g sometimes 80mg when my RLS kick starts (literally) my PAF during most nights! What larks!! Been on Solalol ( such a small amount) for three years and it does make my feet and legs numb. But can't do without it to slow my racing heart when needed. Will make sure I don't ever go on Sertraline. I do hope all ends well for you and it will eventually get out of your system.