Anti anxiety drugs for afib

[Smokas]

Does anybody got prescription for anti-anxiety drugs (e.g. benzodiazepines) for AFib? Was it helpful?

[Popepaul]

I guess that some might argue that Benzos will help in the short term. In the longer term they are likely to be counter productive since they are very addictive. They can occasionally have a paradoxical side effect whereby they increase anxiety. I think that there are better ways to alleviate the symptoms of afib and the anxiety which accompanies the whole experience.

[Smokas in reply to Popepaul]

I fully agree. But IMO they can help as “pill in the pocket” case. When you about to get AFib episode.

[BobD Volunteer in reply to Smokas]

The best cure for AF related anxiety is knowledge and understanding the condition. CBT , deep breathing etc all help. Drugs are just a sticky plaster.

[NewOne2023]

In the beginning of my diagnose I was overwhelmed with anxiety because the whole situation and my GP prescribed me with diazepams and for the first few weeks I took one or two almost every day to calm me down and it worked quite good. But the problem with diazepams is that it doesnt take long to get addicted, in most cases it takes 4-5 weeks of regular use, thats why the box instruction tells you it shouldnt be used for more than 4 weeks. I didn't want another problem in addition to afib so I basically stopped taking them. Nowdays I take it like once a month or so, only when I have a big project working day and I need some calmness. I take 5mg, which for my constitution is just enough to calm my chest anxiety but not put me into groggy state. Another thing to consider is the tolerance. Your tolerance goes up fast, like after 5-10 times of using I already felt that 5mg doesn't have the same effect so I needed to take 10mg. So basically it does with it supposed to do, but you need to be carefull with it since you only can take it for a few weeks before getting hooked. Or you can do what I do nowdays, take it rarely and when the anxiety is really high. Like once a week I think there shouldnt be any long term problems. But then again, I'm no doctor so take my opinion with caution.

[opal11uk]

Totally agree, as always, with Bob. This is a long term condition which we all have to learn to live with, sadly there are no shortcuts but there are ways and methods of living with it and I would not advocate anything which could cause an addiction because at the end of the day that is yet just another thing you have to deal with. Education and informed decision making is the way forward.

[Smokas in reply to opal11uk]

Actually I ment the opposite path - not AFib derived anxiety, but when “external”anxiety source (e.g. sleepless night, stress, etc.) lets to AFib episode. I really like NewOne2023 advice.

I have been diagnosed with BD 20 years ago and managed to deal with panic attacks in the past.

[Barny12]

There is a trial underway in Australia on the use of a common (but unnamed) SSRI for the treatment of afib:

"Study coordinator and EP fellow, Dr Youlin Koh says despite multiple studies noting the relationship between symptoms of depression and AF, there is a need for further investigation to delineate the downstream impact of treating mental illness in AF patients.

“What we hope to achieve with this study is to examine the effects of selective serotonin reuptake inhibitors on heart rhythm,” said Dr Koh. “The autonomic [fight or flight] nervous system is dysregulated in both AF and depression, and these serotonin-based antidepressants have shown improvements in autonomic function in patients with depression.

“We think that through autonomic regulation, they can also reduce AF episodes, showing a dual action on the brain and the heart."

Final results not known until 2026 but preliminary findings could be available 12 months into the trial (2024).

From the Royal Melbourne Hospital research news.

[Ewloe]

anxiety isn’t the cause of af but can aggravate what you already have.

I started sertraline about 18 months ago for generalised anxiety after HA, cardiac arrest, and subsequent heart failure and being left with a few cardiac arrhythmias.

I was already having counselling which was helping but the aim was to avoid further intervention and I’m limited with any anti arrhythmics. after a rocky first few weeks ( they do warn you it can make symptoms worse before they get better), it has helped me to keep my anxiety on a manageable level. I’ve kept on the lowest treatment dose.

I discussed it with my EP and after he went away and looked into the safest drug for me he decided on sertraline.

Nothing in life is risk free. Good luck

[wischo]

Yes I have been taking a small dose of diazapam now since 1976 (almost 50 years) and have never had any ill effects from them at all). I was on higher doses but weaned them down to well below the recommended dosage and find I can not go any lower without ill effects. I have complete tolerance of this dose and would be unaware I had taken them. My GP suggested that should I get an afib attack to take one and an extra beta blocker and it worked well for me. however some people do abuse them which has given them such a bad reputation mostly drug abusers and street dealers. Most heart patients are on medication for life anyway so common sense with them all is key.

[Smokas in reply to wischo]

I used the same approach when I had panic attacks - invoking hypertension crisis. Pill of captopril + diazapam.

[pusillanimous]

I have been on Alprazolam for the last 17 years for anxiety, I am prescribed 0.50mg 3 times per day as required. I seldom take the full dose, but I am sure they help with my PAF which is asymptomatic and familial. I was diagnosed with AF six years ago, see my cardiologist annually, have an echo annually, no changes noted. I seldom have an AF episode, and my cardio has no problem with me taking them - I could be addicted, but I think we become addicted to any long term medication we take for a chronic condition. I find them very helpful, I am 81 and if I'm a druggie, so be it - if I'm found drowned in my swimming pool, they can always blame the Alzam and not the Biso and Xarelto!!!!!!