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SSRI Prozac and heart arrhythmia
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SSRI Prozac and heart arrhythmia

I am depressed & anxiousabout my never ending palpitations. I had an ablation 2+ years ago that zapped one pathway causing 220 tachycardia.since then had non-sustained atria tach at 125, many pvcs, pacs.Last event monitor in March.I had a horrible episode 2 months ago with resting pulse of 140, high BP, PVCS, seen on emergency basis by head of EP dept, said it was panic.That doc, my regular EP doc,my internist all suggested i go on ssri.I am super sensitive to drugs. was on low dose prozac for several years, have been off a long time.Trying to get back on it with liquid,slowly,as did before. on 2.5 mg. a day.PALPS HAVE BEEN WORSE.Wrote head EP doc.he said SSRIs don't cause arrhythmia problems.Regular EP doc says stay on SSRI, no problem.questions:
1.I CAN (*#& READ. Heart arrhythmias are listed as a side effects of prozac in the drug literature. Do cardiologists SEE increased arrhythmia with ssris or NOT?
2.I read prozac has been associated with prolonged QT interval. If i were at risk for this, wouldn't it have shown up on EP test or in EKG years ago when taking 10 mg. of prozac - or not? what IS THE REAL RISK of this?
3.I've had all sorts of palps - skips,thumps,etc. what i'm having now seems to be more pauses.If i take my pulse when happening feels like beat, beat,     beat.I can feel an "all out" and sort of flushed feeling. Any explanation for this?
again, my internist, ep doc, all say my heart has been checked out THOROUGHLY (I even volunteered for a microvolt alternans test when they were training docs to get that test done,it was "strongly negative".i
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74076_tn?1189759432
Hi Lynnsb,

Sorry to hear about your problems.  You must be very frustrated.

1.I CAN (*#& READ. Heart arrhythmias are listed as a side effects of prozac in the drug literature. Do cardiologists SEE increased arrhythmia with ssris or NOT?

I have not seen patients or literature suggesting an increase in arrhythmia's because of an SSRI.

2.I read prozac has been associated with prolonged QT interval. If i were at risk for this, wouldn't it have shown up on EP test or in EKG years ago when taking 10 mg. of prozac - or not? what IS THE REAL RISK of this?

It would have shown up years ago, but should be no problem checking again if you think it will make you feel more assured.  Prozac is not the list of high risk QT prolonging drugs.

3.I've had all sorts of palps - skips,thumps,etc. what i'm having now seems to be more pauses.If i take my pulse when happening feels like beat, beat, beat.I can feel an "all out" and sort of flushed feeling. Any explanation for this?

I don't know why people feel flushed with PVCs or tachycardia, but I hear this frequently -- infact, someone said this to me in clinic today.

It sounds like you are being seen by a lot of very good people.  I hope you find some relief soon.  Thanks for posting.

11 Comments
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Avatar_n_tn
I MEANT to say in question.. when I feel my pulse with my finger on my neck when I'm having these "Pause" kind of palpitations, I do not feel a pause and a thump.. it feels like  a beat "drops" -- like  " beat, beat, ...., beat". any special significance to this?
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84483_tn?1289941537

I am very sorry to hear of your palpitations, sounds as though you've been through living hell with these palps. i have been getting PVCs that triggered a flushed feeling and then caused a fast heartbeat with a very pounding pulse usually in 140-150bpm range, usually last from 1-10 minutes then gone. If I am near a mirror when this happens I can actually see my face , my neck and upper chest all red and flushed, I also break a sweat and shake for a bit the its all gone. I am told this is either classic panic attack or a short lived episode of PSVT, funny thing its comes out of the blue and i dont even be thinking anything that would cause it.

I had my first panic attack in a long time yesterday at a gas station the attendant was filling my tank when all of sudden i felt very lightheaded, not really a skip beat but a sinking feelin in my chest like some had sucked the wind out me, i guess it was a pvc, then my heart for the first time while taking atenolol shot up to about 120bpm, I looked in rear view mirror, i was flushed, then actually turned pale, it lasted maximum 3 mintes and left me shaking for baout a half hour. I almost forgot how horrible they were, i think by bringing my breathing under control and not hyperventilating, also realising what was happening helped to make it very short lived.

Panic attacks and panic disorder, pvcs and tachycardia are very distressing, also make you feels like your're losing your mind. Hope you feel better soon , sound as though yours are a chronic problem, hope you get relief soon.

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Avatar_n_tn
funny you should post about the sinking feeling. I get that exactly. A funny, sinking feeling, I have even said it feels like I am on a roller coaster drop, or going down a big hill in a car. Then my heart rate goes up also. Add anxiety to the mix and stays high for a while. I've had all the tests also, ekgs, echo/stress,etc, and all say healthy heart, feel it is adrenaline triggering it. Tried ssri, but I had anxiety ten-fold on it just in a few days.

You both are not alone on this one!
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Avatar_n_tn
I had a terrible PVC experience on Zoloft.  A couple of years ago I was having somewhat frequent PVCs and it was getting hard to deal with.  My doctor recommended Zoloft.  After just a couple of days my PVCs went crazy, especially with even minimal exercise. At one point I was getting strange beats a few times a minute.  I immediately came off the Zoloft and within a couple of days my PVCs went back to the usual annoying level.
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Avatar_n_tn
thank you. I think clinical experience and the fact you haven't seen ssris linked to serious arrhythmia is very , very reassuring.

Just for the record, here's some interesting literature re: prozac and arrhythmia:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11805215&dopt=Abstract


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11145788&dopt=Abstract

http://jpet.aspetjournals.org/cgi/content/full/300/2/543

http://www.mentalhealth.com/drug/p30-p05.html
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Avatar_n_tn
lynn- many, many medications have palpitations listed as a side effect. its one of those common ones like headache and fatigue. youve probably heard of the placebo effect-- you can give a person a sugar pill and theyll feel better. theres an opposite effect called the nocebo effect, where a patient feels more adverse effects (like palps) when theyre being treated. that might be the case here with the prozac. you just need to relax and quit worrying about them. when i first started getting pvcs, they scared the **** out of me. then i went to a cardiologist, read some studies in medical journals, and got used to them. studies show that if you have a normal heart PVCs will not kill you. worrying about them stresses you out and makes them worse. i know theyre annoying and its hard to beleive feeling your heart stop hundreds of times every day is normal and harmless, but it is. i started excercising 3 times a week and that has *greatly* reduced the amount of pvcs ive been getting. im trying to promote that to people here, its worked better for me than any of the drugs i tried. just relax and try not to think about them, i know its hard to ignore them but you get use to it after awhile. just dont let yourself dwell on them.
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Avatar_m_tn
Also the risk of an arrhythmia with drugs usually only happens if you have an underlying disease. Like how SSRIs can prolong the QT interval it only seems to matter if you have LQTS, but while you are on them it wouldn't be out of the ordinary to request a holter to see if it is prolonging your QT interval into a dangerous level, but that is very unlikely.
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88793_tn?1290230777
I've a lot of that sinking feeling in my chest too.  I told one of the Practitioner that "looks like my heart has dropped some way."  He laughed!  I've the feeling of flushed.  They all said ... MENOPAUSE!  I also have a balloon likes head.  It's light but looks like blow up.  Do anyone has that feeling too?  If it is a symptom of PAC or PVC then I don't have to worry about that.  Now I know that I've PAC or PVC too.  Could someone tell me a little bit more of the PAC or PVC symptom?  Thanks.  Pika.
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Avatar_n_tn
I almost hate to post because im afraid it will jinx my recovery. About a year ago i saw an ep for frequent pvc. I had them for about a year and he gave me a scrip of toprol xl 25 mg. I had borderline hypertension so i continued to take them. Throughout the summer there wasnt much relief except at times they subsided. However the last 3 months they have become very infrequent to the tune of no more than 20 or 30 per day. With one exception, i had an emotional day  and the following day they were with me about every 20th beat( which before for the last 2 years they were at times coming to the tune of 6 a minute. My point is im not sure if the toprol is having a longterm effect or if im in a grace period. I hope the toprol is working. The only negative effect is extremely vivid dreams which i can live with as long as i wake up from them!!! I went thru some dark days with these things as most who have them can relate to. Dont give up hope.... yours truly
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Avatar_f_tn
I know someone who had their prozac raised in level of milligrams and it was way to much for them to handle and they had a panic attack that sent them to the ER in ambulance....be careful with prozac..and do not just stop taking it , its another that needs to be weaned down.
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