Anxiety medication

[rothwell]

I have been suffering from anxiety and feeling occasionally depressed for several months now, I have a friend who takes Sertraline which she says helps. When I looked at side effects of this it gave arrhythmia as a possible side effect. As I have paroxysmal atrial fibrillation I don’t want to make the situation worse. Does anyone take this or any other medication for anxiety without it appearing to bring on further episodes of AF? Have discussed with my GP who does not have the answer to this and have looked up other medications but this side effect frequently appears.

[Rambler398]

You are right. Prolongation of the QT interval on a baseline ecg may well be a contraindication to prescribing an SSRI.

That said, when I had paroxysmal AFib, I didn’t have an ecg before starting Sertraline (2010) which the GP said was the safest of the SSRIs for patients with cardiac problems. I was fine and it was very effective.

Below is an extract from a relevant article

“Current guidelines by the American Heart Association recommend monitoring a baseline QTc before initiating any agent that may prolong the QTc interval, at the onset of any new bradyarrhythmias, severe hypokalemia or hypomagnesemia, or over dosages of known proarrhythmic pharmacotherapy agents”

I am not a health care professional.

[secondtry]

Anxiety is definitely something to get on top of; I speak from similar experience when first diagnosed. I don't favour more medication due to the risk of side effects.

The four main things that reduced mine was: avoid other stress areas, focus on a new hobby or enjoyable work, prayer and walks where close to Nature.

[Pommerania78 in reply to secondtry]

How are you doing nowadays?

[Ppiman]

Sertraline is used and I am quite sure in some people, it can help. I've read the effect is in maybe 30-40%, which isn't far from what placebo drugs do, so I remain unconvinced that it is the "go to" choice. It's also an SSRI drug and they have come under the spotlight for many good reasons of late. I was given one of this family of drugs in the early 2000s after a series of family tragedies, to help with anxiety. I reacted badly to them and my advice to anyone is to search for other treatments, first. That said, some (many?) do find relief, but anxiety and depression are such personal things that one person's experience will likely be different from another's.

I would, honestly, first seek alternative ways to help. The older, now but still thoroughly excellent and unsurpassed books by the Australian Dr Claire Weekes would be a good start for you. There's one called "Self Help for the Nerves" - nothing better has been written or could be prescribed, in my view.

Life with "nerves", whether anxiety or low mood and depression, is tough going. You have my deepest sympathy but keep in mind that time itself will help you. These things always lift, even if to return, it's true, but they do and will always lift. If that happens to coincide with some kind of treatment, then it's easy to think we have found a "cure", when all that has happened is an upturn in mood.

Steve

[Vonnegut]

Why not try breathing exercises, meditation or mindfulness? That would be better than starting on drugs which may come with more problems!

[BaileyC57]

I have anxiety and I take medication called alprazolam 0.25mg and I cut it in half. I take this with all my AFIB meds! This might help !

[JudyMarieC]

Like BaileyC57, I also have alprazolam 0.25mg which I cut in half and use when I wake up at night and can't get back to sleep. It has no effect on my afib and has actually calmed it down at times when anxiety kicks in.

[Vonnegut in reply to JudyMarieC]

If you took Flecainide (as PIP) then, it would calm your heart down and get it back to normal in a few hours so you could get back to sleep and “Don’t panic!”

[JudyMarieC]

I meant to say that it has no negative effects with regard to my afib.

[Palpman]

We must remember that anxiety is not the same as depression and are treated differently.

The OP is on Sertraline which is a mood enhancer and takes weeks to be effective.

Alprazolam is a diazapine which is quick acting and used for anxiety.

I was on both when first treated for panic attacks but turned out to be tachycardia attacks (AVNRT) causing my panic attacks.