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paxil
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paxil

1 A. Why would paxil be prescribed for neurocardiogenic syncope   and/or sinus tachycardia?  B.Would it be because someone had the side effect of depression on a higher dose of beta-blocker?    2. If someone has the side effect of depression is it purely a side effect? I have been through a lot of tough things in my life-time and never experienced side effects until the beta-blocker.  3. I think I am beginning to understand the neurocardiogenic syncope. I am right in thinking that even with the medication I will have good days and bad days?
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Dear anon,
Paxil (generic - paroxetine) is a member of the serotonin reuptake inhibitor (SSRI) class of drugs.  These drugs are used to treat depression but they are also active in treating neurocardiogenic syncope (NCS).  Serotonin is involved in many cardiovascular reflexes including the ones responsible for NCS.  Some studies have indicated that the SSRI's decrease the frequency of symptoms in patients diagnosed with NCS.  For this reason it is sometimes used as treatment.
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I too take paxil.  I started out taking 20 mg a day and now I am back down to 10mg.  I would have the following symptoms:  Racing heart, sweating, palpitations, chest pain,elevated blood pressure and "fear of death" thoughts.  I went to the ER several times thinking I was having a heart attack because I had all of the symptoms.  After several EKGs and other tests, I was diagnosed with having panic attacks.  There are several "triggers" that I have to be careful to eleminate.  Caffeine and cheddar cheese are the biggest triggers for me.  But the paxil has helped tremendously.  I am also being treated for mild left ventricular hypertrophy.  I take Toprol 12.5 mg once daily and Altace 2.5mg once daily.

Good luck!
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