Is anti-anxiety med too risky for arrhythmias?

[LCM79]

Hi everyone,

I’ve struggled with anxiety most of my life but it’s increased a lot since my SVT diagnosis 3 years ago. I have AVNRT & Atrial Tachycardia and take 1.25mg bisoprolol daily.

I’ve tried meditation, yoga etc but I just can’t seem to get my anxiety under control. My question is, will the anxiety medication sertraline increase my risk of getting more arrhythmias? Would love to hear your experiences.

thank you!

[etheral]

According to Merck Sertaline is not indicated for general anxiety disorder. It's main use is as an anti depressant. It is also relatively contraindicated for people with arrythmias and CAD. Personally I would think a low dose of a benzodiazapine such as dtazapam or Ativan would be safe and possibly effective. There are no cardiac interactions with this class of drugs. There is however a chance of addiction if used improperly. Consult your physician regarding these statements. Best etheral

[Karendeena in reply to etheral]

I take 2.5mg of diazepam if I get very anxious especially at night. My GP only gives me 15 pills and they have to last me about 2 months. My EP doesn't recommend sertraline and wanted me off citalopram.

[Popepaul]

Ethereal above is correct, sertraline is an anti depressant. Benzodiazepine medications are often prescribed to treat acute episodes of anxiety they are very often effective for short term use. Unfortunately they are often addictive and long term use is likely to exacerbate your experience of anxiety. I think it is fair to say that many psychotropic medications can have a secondary calming effect and hence reduce anxiety to a degree. Perhaps your Dr has this in mind. Your Dr may of course think that your anxiety is brought on by low mood.CBT can be very helpful for the treatment anxiety, either as a primary treatment or as a supplement to pharmacology.

Regards

[Blearyeyed]

Out of all the antidepressant options available Sertraline in studies , showed the least risk of adverse effects on patients with Arrhythmias which is why it's often the option suggested to trial from a low starting dose ( basically a dose much lower than the one that you will eventually take to show a significant change in your condition to test for side effects) if you have Depression and Arrhythmias as comorbidities.Most antidepressants do have a risk of increasing your heart rate.

Although the medication is more generally used for Depression than Anxiety Disorders.

Has this drug been suggested to you by a GP or Specialist ?

The best thing you can do is contact your original Arrhythmia specialist , either by ringing or emailing them via their Secretary, and ask them if they think it would be appropriate for you to try in your current point of heart management and whether it is suitable to take with your other medications. It's always a good idea to double check these things with the different Specialists you have for each condition as obviously a mental health specialist may not know the risks and benefits of their treatment for a heart condition because it is not their area of expertise.

[Ewloe]

I developed generalised anxiety after my heart attack in July 21. The heart attack left me with bits of PAF ( was continuous AFib for 3 months until a cardio version), NSVT, and SVT.

I went to counselling and discussed the anxiety issue with my EP. he felt medication was an appropriate option. Anxiety isn’t the cause of the arrhythmia’s but will aggravate what’s there.

He went away and looked into the best medication with my heart damage and arrhythmia’s and decided sertraline was the ‘safest’.

It’s given me my life back. I’m on 50mg which is the lowest treatment dose. Sertraline is prescribed for generalised anxiety. It does make symptoms worse for first week but then improves it. Good luck. Anxiety is an awful feeling.

[Easternmost]

Hi,

I found CBT therapy helpful for anxiety. I too have SVT. I have reached a point where I still think about it and worry about doing things which might trigger an episode, but as many wise people on here will tell you, try and reach a point of acceptance about the condition, feel reassured that there are treatments available and don’t let it define you. Anxiety and SVT seem to be co- dependant in my case. You are not alone. Wishing you the best.

[Ppiman]

I am similar to you regarding the fears that bedevil my mind regarding health issues. It can be agony at times.

Sertraline is an SSRI. As with all drugs in that now large class, it works in mysterious ways as a recent major review and study showed. It was originally sold to treat depression. Anxiety is sometimes linked with that and that’s how these drugs started to be given for that. Their effective is not great with, at best in studies, 30-40% effectiveness if I recall - not far from a placebo in other words.

For an anxious mind, SSRIs, sometimes called “activating” antidepressants, the side effects can be harsh. I gave up with them after twelve weeks (citalopram - similar to sertraline).

The only true anxiolytic drugs seem still to be the benzodiazepines such as diazepam (Valium). These have their own risks of dependency in about a third of those who take them and so are shunned by many doctors. They are very far from cures, too. But they are often helpful for short term and emergency use

If meditation and CBT have failed, I would rather choose Valium than an SSRI. Better than all is to have the fear quantified and likely heavily reduced by talking to your doctor or a specialist I have found, even if privately.

That’s my own experience. You can send me a private message if you ever feel the need and I’ll try to help further. It’s a tough life having an anxious mind.

One final thought. On Amazon and eBay you’ll still find out of print, second hand books by Dr Claire Weekes on self help for the nerves. They are wonderful.

Steve

[DKBX]

I’ve always thought anxiety should be treated for those of us with arrhythmias. Give it a try.

[obikinobi]

A lot of doctors think anxiety is the cause when in fact, the thyroid is to blame. I had heart palpitations, arrythmia and tachycardia when my thyroid was .4 Had all heart tests and labs and they said it must be stress/anxiety. My naturopath tested my thyroid and I reduced my thyroid meds. I was taking bisophrolol because they didn't re-test my thyroid. Now I am slowly filing off the bisophrolol tablel to get off it. It caused tinnitus. Thyroid should be in the 1-2 point range and up to 2.5 if older. Check out the Thyroid Doctor website (Isabella Wentz DPharma) for thyroid info.

[Paulbounce]

Hi Lcm.

I'm on it - 50mg a day. No problems at that low dose. My cardio said if it needs to in be increaesed go up to 75mg max. To high a dose can bring on afib.

All best Paul