Antidepressant for microvascular Angina and Mitral valve regurgitation

[AuntyEdna]

I have both the above and the cardiologist approved me taking Certraline for stress, I’ve been taking 39mg daily for several years. However at this years medication review our Drs pharmacist informed me I can only take 20mg daily because I am over the age limit for more. Reducing it kicked off my headaches and anxiety. So the next month she gave me Fluoxetine 20mg- this was much worse , my migraines returned with a vengeance - I have Occipital nerve blocks for these and am usually pain free for two months out of three. To add insult to injury other symptoms kicked in including angina, panic moments and upset tummy. Question do any of you good people know of another anti anxiety pill that works ok with MVA and MVR so I can suggest alternatives to the pharmacist who is ‘checking up on me ‘ this week after a month or two ( I’ve had two very nasty angina attacks lasting 20-30 mins during this time both in the car - I wasn’t driving)😬 many thanks for reading this 🫠

[Nanny1971]

I have taken venlaflaxine for years I find it really good for my anxiety and depression and it works for hot flushes in menopause check that one out for yourself 🌸

[AuntyEdna in reply to Nanny1971]

Thank you for this - Sound s like that might work, I took it for a while before the cardiologist worked out what was going on with my heart and then found I also had hypothyroidism - it was a very rocky time 😬

I went into the menopause at 49 hot flushes dreadful and still get them now and then ( I’m 66 now) 😊

[Milkfairy Heart Star]

Hello,

I suggest you ask your Cardiologist what they would recommend?

Microvascular angina isn't a well understood condition. I wouldn't expect your GP's Pharmacist to be knowledgeable about MVA

I have never taken antidepressants, however I am prescribed very high doses of Diltiazem and Ivabradine even though it's not recommended.

Recently a GP at my surgery decided they would stop my Ivabradine and reduce my dose of Diltiazem on my repeat prescription. I asked them to contact my Cardiologist.

My repeat prescription duly amended, I continue with my high dose of Diltiaziem and Ivabradine.

[AuntyEdna in reply to Milkfairy]

Hi I am taking Diltiazem 180 per day and Ranexa 2x500 which I think is standard. It was the cardiologist who completed my angiogram who encouraged taking the Citalopram he thought it would help me . The added conundrum I have is I was born with an enzyme missing so can’t metabolise sucrose sorbitol fructose and polysorbate , there are lots of sugars that break down to yield some of these too. It makes excipients tricky I have to read labels and have named branded meds - not all medical staff understand so when I’m changed to other meds the nightmare begins again.

I’ll see what I can sort out this week with the pharmacist at the Drs. To be honest I haven’t see or spoken to an actual Dr at my practice for over two years only nurse practitioners or the pharmacy although I have spoken with two different cardiologists on the phone in that time for route checks. I’m old fashioned I still prefer face to face .

Take care 😊

[Callie456]

I would speak to your actual doctor about going back on the original medication and dose which was working for you. There are always cases where the benefits for you outweigh the risks and consequences of changing. Just because you turn a certain age doesn't mean that you can't stay on a higher dose. Yes there may be increased incidence of the med affecting kidneys or something (I don't know, but thats a common reason they give lower med doses to older age groups) But, that doesn't mean it will be a problem for you. It may just mean that you need regular blood tests to check that it isn't causing any problems and if it is, then there would be a reason to consider changing.I would stay on the original dose, you know your body and what works for you.

[AuntyEdna in reply to Callie456]

Thank you for your wise words I do appreciate it and I’m coming to the same conclusion.

The trouble with this sort of thing is accessing a Dr here they farm out their responsibility to other staff in their surgery. Some times it works fine but sometimes it doesn’t. Our Drs have reduced down from five to two even though there’s are at least a third more patients on the books than five years ago. What is going on ! Bizarrely there was better service during the pandemic.

I’ll talk to the pharmacist later today and see how I get on.

Take care 😊

[Silvertail]

I am now on Tegretol (Carbamazepine) for my neuropathy, but have found I now have increased confidence (with driving etc.) and a much calmer outlook. Sertraline did not treat me well.

[charlotte_3]

I have been taking Mirtazapine 15mg for 6 months and it has been a live saver for me. Has reduced heart and body pains, improved breathing, mobility and reduced anxiety. I could not imagine being without it now. Doctor also gave me Amitriptyline 10mg to take as and when required which also helps but more side effects with it. I know these drugs don't suit all heart conditions but worth discussing them with your doctor. I hope you get sorted with something soon.

[AuntyEdna]

hi Charlotte thank you for this certainly worth keeping this one in mind. I had my consultation yesterday and we’re trying 30mg of Fluoxetine for a month- 20mg gave me bad heads and 40mg palpitations 🤦🏻‍♀️

If this doesn’t do the trick I’ll suggest Mirtazapine

Have a good week end , take care 😊