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Arrhythmias possibly helped by taking SSRI
I found something very interesting on Pubmed concerning taking SSRIs with arrhythmia. Here is the site: http://www.ncbi.nlm.nih.gov/pubmed/20838725
This is actually about CPVT, which I am not sure I have. CPVT is polymorphic, and inherited. So far the doctors don't think I have an inherited VT, although they are not sure yet what causes mine. Anyway, the Lexapro is helping me tremendously so far.
I have PVCs and non-sustained runs of v-tach. My problems started about 4 months ago. I was extremely anxious, was having frequent PVCs and then a non-sustained run of v-tach on a treadmill stress test. I was also having chest pains. The doctors did several tests, heart cath, cardiac MRI, echocardiogram, one month heart monitor, all normal, except for PVCs on the one-month monitor. The EP also did another treadmill at the hospital and I had frequent ectopic beats with exercise, but no v-tach. I was on the Lexapro at that time.
Since starting the SSRI Lexapro, 5 mg. (for anxiety/depression), my chest pains have disappeared and I rarely feel PVCs. Has anyone else experienced this with SSRIs? I haven't asked the EP his opinion about this yet.
This is actually about CPVT, which I am not sure I have. CPVT is polymorphic, and inherited. So far the doctors don't think I have an inherited VT, although they are not sure yet what causes mine. Anyway, the Lexapro is helping me tremendously so far.
I have PVCs and non-sustained runs of v-tach. My problems started about 4 months ago. I was extremely anxious, was having frequent PVCs and then a non-sustained run of v-tach on a treadmill stress test. I was also having chest pains. The doctors did several tests, heart cath, cardiac MRI, echocardiogram, one month heart monitor, all normal, except for PVCs on the one-month monitor. The EP also did another treadmill at the hospital and I had frequent ectopic beats with exercise, but no v-tach. I was on the Lexapro at that time.
Since starting the SSRI Lexapro, 5 mg. (for anxiety/depression), my chest pains have disappeared and I rarely feel PVCs. Has anyone else experienced this with SSRIs? I haven't asked the EP his opinion about this yet.
I developed heart block from prozac. I read celexa can cause a deadly rythm over 40mg., I know my cardiologist told me to get off an antidepressant I was on for CFS because he said they caused dangerous rythms. Personally I despise them and have zero trust in them.
I have malignant arrhythmia's (polymorphic VT) and tried Lexapro but didn't have any symptom relief. I'm going to try Lamictal this wknd because my EP did say there were 5 or 6 ssri's or mood stabilizers that have been proven to help with some arrhythmia's.
I'm hoping this will be my one that helps because no bb's have helped with my pvc/VT runs completely. Inderal LA has been helping somewhat but I still get my daily runs.
back when I had my stress test, it showed alot wrong and I fainted from a VT run but they didn't seem to be concerned about it and didn't find my problem until I went for my EP Study, so it's good if you do have a dangerous problem they find it sooner rather than later.
I'm hoping this will be my one that helps because no bb's have helped with my pvc/VT runs completely. Inderal LA has been helping somewhat but I still get my daily runs.
back when I had my stress test, it showed alot wrong and I fainted from a VT run but they didn't seem to be concerned about it and didn't find my problem until I went for my EP Study, so it's good if you do have a dangerous problem they find it sooner rather than later.
Thanks for the info. I looked Celexa up, and yes, you are right about the high dosage causing arrhythmia. How long were you on the Celexa?
Right now I am taking a small dose, only 5 mg. of Lexapro, and I have only been on them a couple of months. But I will certainly ask my EP next appointment in about 3 weeks if they are safe for me. Another doctor had prescribed them.
The article I mentioned from Pubmed doesn’t say what strength of SSRI was being used for that patient. Also, it may be that they are safe for patients with certain types of arrhythmia and not others, not sure. I talked with someone else about this on the “Inspire” site who had long-standing problems with CPVT, and she said she was “the poster child” for Lexapro.
I will certainly investigate this further. I do feel a patient should ask their own doctor before trying them.
Right now I am taking a small dose, only 5 mg. of Lexapro, and I have only been on them a couple of months. But I will certainly ask my EP next appointment in about 3 weeks if they are safe for me. Another doctor had prescribed them.
The article I mentioned from Pubmed doesn’t say what strength of SSRI was being used for that patient. Also, it may be that they are safe for patients with certain types of arrhythmia and not others, not sure. I talked with someone else about this on the “Inspire” site who had long-standing problems with CPVT, and she said she was “the poster child” for Lexapro.
I will certainly investigate this further. I do feel a patient should ask their own doctor before trying them.
I hope the Lamictal works for you. I know from when you responded to my other post that you have been through a lot. I am shocked that when you fainted from VT on your stress test that they didn’t seem to be concerned. I think my cardiologist would have fainted himself if I had done that. He said I “scared him to death” and mine wasn’t even a long run. Maybe some doctors try to not show concern so as to not upset the patient. Not sure.
The Lexapro (my neurologist prescribed it) has helped me, but I take a low dose (5 mg.) and have only been on it a couple of months. I am going to ask my EP about it in about 3 weeks. I haven’t tried the BB yet. My problem just developed about 4 months ago and the doctors still haven’t given me a diagnosis (not unusual, from what I am reading). My second opinion EP talked about doing the BB with me, but they drive my pulse pretty low, so I am not sure. He mentioned putting me on them and doing another treadmill to see it they worked, but then he turned me back over to my cardiologist without investigating further. I had to insist on another appointment. Grrrr!!!
I was wondering, do you know when you have a shorter run of VT (when you don’t pass out)? Do you get light-headed? My first EP thinks I am having short runs, but he said I probably would not know unless they were long enough to have symptoms. I have had lots of light-headedness in the past. I did notice the other day my heart was doing something strange, so I checked my pulse and caught a short run of VT. I had taken some left over Oxycodone for pain because I hurt my neck, but not sure if that caused it.
The Lexapro (my neurologist prescribed it) has helped me, but I take a low dose (5 mg.) and have only been on it a couple of months. I am going to ask my EP about it in about 3 weeks. I haven’t tried the BB yet. My problem just developed about 4 months ago and the doctors still haven’t given me a diagnosis (not unusual, from what I am reading). My second opinion EP talked about doing the BB with me, but they drive my pulse pretty low, so I am not sure. He mentioned putting me on them and doing another treadmill to see it they worked, but then he turned me back over to my cardiologist without investigating further. I had to insist on another appointment. Grrrr!!!
I was wondering, do you know when you have a shorter run of VT (when you don’t pass out)? Do you get light-headed? My first EP thinks I am having short runs, but he said I probably would not know unless they were long enough to have symptoms. I have had lots of light-headedness in the past. I did notice the other day my heart was doing something strange, so I checked my pulse and caught a short run of VT. I had taken some left over Oxycodone for pain because I hurt my neck, but not sure if that caused it.
For decades I have had bouts of pvcs, shown by repeated testing to be monofocal and benign. These attacks occur every few years and are always accompanied by panic attacks without any apparent trigger other than perhaps change of season. Over time and with the help of a knowledgeable shrink, I have learned that these attacks are perfectly controllable with low-dose Zoloft for a few months, after which I taper off. I am a fast responder,and within a few days, my PVCs become less and less noticeable, and in fact less frequent, until they disappear.
I have had the same experience with Celexa (though with some weight gain). For me, this has been such an effective treatment that I would have no hesitation recommending it to others who suffer from benign PVCs. But for many, the idea of taking medications, particularly psych meds, is very difficult to overcome.
As a side note, some of the older antidepressants of a different class were fairly strongly associated with some kinds of arrhythmias. Although ectopic beats of various types are always listed as possible side effects with the new SSRIs, they are in fact fairly rare--unless one is also taking certain other meds at the same time. A good psychiatrist will know which medications are more or less likely to be involved.
I have had the same experience with Celexa (though with some weight gain). For me, this has been such an effective treatment that I would have no hesitation recommending it to others who suffer from benign PVCs. But for many, the idea of taking medications, particularly psych meds, is very difficult to overcome.
As a side note, some of the older antidepressants of a different class were fairly strongly associated with some kinds of arrhythmias. Although ectopic beats of various types are always listed as possible side effects with the new SSRIs, they are in fact fairly rare--unless one is also taking certain other meds at the same time. A good psychiatrist will know which medications are more or less likely to be involved.
Thanks so much, Achillea, for your response. I am glad you have found something to help your PVCs.
I also tend to get very overwrought and possibly am panicking too at times with these. Both my husband and I have a family history of heart disease, and my husband has an ICD because of CAD. But I didn't know too much about the rhythm problems until I developed them about 4 months ago. I frightened my cardiologist with a treadmill test, then underwent several tests, which were normal (except for 2 treadmill tests). My problems develop with exercise or stress. But so far two EPs have not come up with a diagnosis for me. I am told it is nothing to worry about, but with frequent PVCs and runs of v-tach it is hard not to worry. One of the EPs said we could try ablation but the other said he didn't think that would work for me.
I am glad the SSRI, Lexapro is helping me. I had a response similar to yours with the medication. The PVC's have become less and less noticable, and are much less frequent. Thanks for the info.
I also tend to get very overwrought and possibly am panicking too at times with these. Both my husband and I have a family history of heart disease, and my husband has an ICD because of CAD. But I didn't know too much about the rhythm problems until I developed them about 4 months ago. I frightened my cardiologist with a treadmill test, then underwent several tests, which were normal (except for 2 treadmill tests). My problems develop with exercise or stress. But so far two EPs have not come up with a diagnosis for me. I am told it is nothing to worry about, but with frequent PVCs and runs of v-tach it is hard not to worry. One of the EPs said we could try ablation but the other said he didn't think that would work for me.
I am glad the SSRI, Lexapro is helping me. I had a response similar to yours with the medication. The PVC's have become less and less noticable, and are much less frequent. Thanks for the info.
I took an SSRI (Zoloft) for about two years until I couldn't stand the anxiety, rapid pulse, internal shakiness and noticable hand tremors I got from it. I wasn't on a high dose either. The doctor told me to stop. I weaned myself off over a period of months, because I was one of those that couldn't just taper off quickly.
So, it helped me for a little while, but soon the side effects kicked in and I had to quit.
So, it helped me for a little while, but soon the side effects kicked in and I had to quit.
I don't think they worried about my stress test too much because at that point, they had only done ekg's, 24 holter and an echo. Things looked benign even though I had very frequent pvc's (50,000) vt runs, fainting, chest pain and had bouts of dizziness and fainting episodes. They didn't find out until later that my pvc's/vt were multifocal and dangerous.
Here's my test results -(age 42) 7/6/2009 Stress test: 4:55 min test
Resting - Sinus rhythm with slow R wave progression in the precordial leads
Stress - Frequent pvc's w/ 2 PVC couplets and 1 PVC triplet in recovery [1 min]
Sinus Tachycardia with no signifiant ST-T wave changes
QRS segment of PVC's narrowed substantially with exercise, widening again in recovery (180 ms to 80 ms)
BP - 130/70 - 150/90
Heart rate response: resting 74 bpm, peak 154 bpm, 87% age predicted maximum. 1 min into recovery heart rate decreased to 121 bpm
Functional aerobic impairment of 35% 6 mETS achieved
Increasing Dyspnea was noted with exercise stress as well as increasing dizziness. Nausea was noted in recovery and I fainted.
Luckily my EP didn't stress or freak out over my symptoms or results. I don't think he would have been able to handle my complications during the ablation if he had, now THAT scared his socks off he said =)
He had never had anyone else flat line and not convert back before the count down and when I didn't respond to the first shock he didn't want to shock me so close together in the first sustained run and thought I was gone; I'm stubborn...on the 2nd run he waited and luckily on the 3rd run I converted back at the last count
I have pvc's, vt, pac's psvt runs daily, but still not alot of answers other than dr's think it's my ANS system causing the major problems and that's where the adrenaline driven ones are coming from. I have frequent episodes of lightheadedness, headaches, brady-tachycardia's, weakness & fatigue, dizziness & vertigo, nausea and fainting.
I believe if you had CPVT; it would show on the tests you've had as [wracking my brain] bi-directional VT? I believe Is_something_wrong said it was - although when I mentioned it to my dr he asked where I heard that and I told him I had researched malignant arrhythmia's...he patted me on the back and said no dear one of the dr's would have picked that up by now.
Right now I'm stuck with the HOCM diagnosis until I can go to the hypertrophic cardiomyopathy specialist in S. FL (waiting on appt) and get him to say yes or no; but I have my doubts.
its'a good sign that lexapro is working for you; and I understand about low hr/bp with some bb's - mine will tank so low on some not even the ER could stabilize mine above 70/40 bp 40 hr.
Here's my test results -(age 42) 7/6/2009 Stress test: 4:55 min test
Resting - Sinus rhythm with slow R wave progression in the precordial leads
Stress - Frequent pvc's w/ 2 PVC couplets and 1 PVC triplet in recovery [1 min]
Sinus Tachycardia with no signifiant ST-T wave changes
QRS segment of PVC's narrowed substantially with exercise, widening again in recovery (180 ms to 80 ms)
BP - 130/70 - 150/90
Heart rate response: resting 74 bpm, peak 154 bpm, 87% age predicted maximum. 1 min into recovery heart rate decreased to 121 bpm
Functional aerobic impairment of 35% 6 mETS achieved
Increasing Dyspnea was noted with exercise stress as well as increasing dizziness. Nausea was noted in recovery and I fainted.
Luckily my EP didn't stress or freak out over my symptoms or results. I don't think he would have been able to handle my complications during the ablation if he had, now THAT scared his socks off he said =)
He had never had anyone else flat line and not convert back before the count down and when I didn't respond to the first shock he didn't want to shock me so close together in the first sustained run and thought I was gone; I'm stubborn...on the 2nd run he waited and luckily on the 3rd run I converted back at the last count
I have pvc's, vt, pac's psvt runs daily, but still not alot of answers other than dr's think it's my ANS system causing the major problems and that's where the adrenaline driven ones are coming from. I have frequent episodes of lightheadedness, headaches, brady-tachycardia's, weakness & fatigue, dizziness & vertigo, nausea and fainting.
I believe if you had CPVT; it would show on the tests you've had as [wracking my brain] bi-directional VT? I believe Is_something_wrong said it was - although when I mentioned it to my dr he asked where I heard that and I told him I had researched malignant arrhythmia's...he patted me on the back and said no dear one of the dr's would have picked that up by now.
Right now I'm stuck with the HOCM diagnosis until I can go to the hypertrophic cardiomyopathy specialist in S. FL (waiting on appt) and get him to say yes or no; but I have my doubts.
its'a good sign that lexapro is working for you; and I understand about low hr/bp with some bb's - mine will tank so low on some not even the ER could stabilize mine above 70/40 bp 40 hr.
Momtofour85, thanks for your response.
Oh my gosh!! Were you in flat line the whole time and had to have 3 shocks to bring you back from it? That is so mind boggling!! I am sorry you had to go through with that. Does it make you anxious to talk about it? I just have no words that could express my astonishment. I am so glad that you are OK!!
I haven’t looked into the ANS system as a possible cause of VT and PVCs. Mine are also adrenaline driven, so I need to do more research. I also have episodes of lightheadedness, dizziness, sometimes off and on for days, but I have never passed out from it. I went through several tests at times during my life but the doctor could not find the cause. This is like a puzzle, isn’t it, where you find a piece that fits here and there, until finally you have a diagnosis. I need to find out for sure if my VT was monomorphic or polymorphic. My cardiologist said monomorphic, but I haven’t asked the EP yet. Also, I talked to one person that said the doctor for years thought hers was monomorphic until she had an ablation, and then they found she had a dangerous polymorphic VT.
I am very pleased so far with the results I am getting by taking the Lexapro, although I don’t know how long it will continue to help. I think it may help in some cases, with certain VT. Mine seems to be adrenaline driven.
I hope your doctors can get to the bottom of your problems and give the right diagnosis. You have been through so much. That is a very low bp and pulse when you take the beta blockers. My EP said they sometimes give a pace-maker to bring the pulse back up if the BB is helping your symptoms but your pulse is too low. I can’t remember if you said before on another post to me, but do you have an ICD? Sure sounds like you would be a candidate for one.
Oh my gosh!! Were you in flat line the whole time and had to have 3 shocks to bring you back from it? That is so mind boggling!! I am sorry you had to go through with that. Does it make you anxious to talk about it? I just have no words that could express my astonishment. I am so glad that you are OK!!
I haven’t looked into the ANS system as a possible cause of VT and PVCs. Mine are also adrenaline driven, so I need to do more research. I also have episodes of lightheadedness, dizziness, sometimes off and on for days, but I have never passed out from it. I went through several tests at times during my life but the doctor could not find the cause. This is like a puzzle, isn’t it, where you find a piece that fits here and there, until finally you have a diagnosis. I need to find out for sure if my VT was monomorphic or polymorphic. My cardiologist said monomorphic, but I haven’t asked the EP yet. Also, I talked to one person that said the doctor for years thought hers was monomorphic until she had an ablation, and then they found she had a dangerous polymorphic VT.
I am very pleased so far with the results I am getting by taking the Lexapro, although I don’t know how long it will continue to help. I think it may help in some cases, with certain VT. Mine seems to be adrenaline driven.
I hope your doctors can get to the bottom of your problems and give the right diagnosis. You have been through so much. That is a very low bp and pulse when you take the beta blockers. My EP said they sometimes give a pace-maker to bring the pulse back up if the BB is helping your symptoms but your pulse is too low. I can’t remember if you said before on another post to me, but do you have an ICD? Sure sounds like you would be a candidate for one.
Thanks for your response.
I have only been on the Lexapro, 5 mg. for about 2 months, but yesterday, yes, I seemed to be a little nervous. So I don't know for sure. It has helped tremendously with my palpitations and chest pains. I hope I can continue on it and it will continue to help without causing the problems you are experiencing. Were you having problems with PVCs also?
I am also going to check with my EP to find out what he thinks about the SSRIs helping with the symptoms some of us are experiencing.
I have only been on the Lexapro, 5 mg. for about 2 months, but yesterday, yes, I seemed to be a little nervous. So I don't know for sure. It has helped tremendously with my palpitations and chest pains. I hope I can continue on it and it will continue to help without causing the problems you are experiencing. Were you having problems with PVCs also?
I am also going to check with my EP to find out what he thinks about the SSRIs helping with the symptoms some of us are experiencing.
During my ablation my EP found 3 separate sites that he hit and I went into long sustained runs of P-VT and had to be shocked. I think they were found in the RV apex, bundle of HIS & RVOT can't quite remember what 2 are called and those 2 may be the same spot - if you look in my pictures in my profile the EP Study is in there.
Since I had lifelong fainting and profound bradycardia episodes as well as VT runs, he wanted to implant an ICD. I had a Teligen 100 pacemaker/defibrillator implanted a few days after surgery and a ton of testing to figure out what was going on.
All tests I had from June 2009 - August 2009 when I had my ablation showed I had monomorphic VT and benign pvc's...that is until I had the EPS.
I found out a year later the ER actually froze my files (long story) because of a court case I was going through with my insurance company and no one was allowed to see my records; so my EP had no clue the ER records showed heart enlargement, suspicions of congestive heart failure and multi focal pvc's. I'm not sure how much of a difference that would have made but at least the EP would have had the information.
After the procedure I started having nightmares about it and developed PTSD and still have them 2 years later. It's difficult remembering and talking about it; but it's a form of therapy also.
My bp/hr on Inderal has been pretty good and stayed stable for the most part; it's the hemodynamic response to postural things I think that bothers me the most - moving side to side, standing, sitting upright because the blood doesn't quite do what it's supposed to do.
The national dysautonomia research foundation ndrf.org has a patient handbook about the ANS that is really good and easy to understand if you look on their website; the CL of the dysautonomia forum here gave me the link back in 2009 when I questioned my ANS issues.
It's a very good sign the ssri is helping you; very encouraging and may be the answer for you.
Since I had lifelong fainting and profound bradycardia episodes as well as VT runs, he wanted to implant an ICD. I had a Teligen 100 pacemaker/defibrillator implanted a few days after surgery and a ton of testing to figure out what was going on.
All tests I had from June 2009 - August 2009 when I had my ablation showed I had monomorphic VT and benign pvc's...that is until I had the EPS.
I found out a year later the ER actually froze my files (long story) because of a court case I was going through with my insurance company and no one was allowed to see my records; so my EP had no clue the ER records showed heart enlargement, suspicions of congestive heart failure and multi focal pvc's. I'm not sure how much of a difference that would have made but at least the EP would have had the information.
After the procedure I started having nightmares about it and developed PTSD and still have them 2 years later. It's difficult remembering and talking about it; but it's a form of therapy also.
My bp/hr on Inderal has been pretty good and stayed stable for the most part; it's the hemodynamic response to postural things I think that bothers me the most - moving side to side, standing, sitting upright because the blood doesn't quite do what it's supposed to do.
The national dysautonomia research foundation ndrf.org has a patient handbook about the ANS that is really good and easy to understand if you look on their website; the CL of the dysautonomia forum here gave me the link back in 2009 when I questioned my ANS issues.
It's a very good sign the ssri is helping you; very encouraging and may be the answer for you.
I am outraged that your EP did not have access to such critical information about your heart enlargement. I did not know this Lisa and I find it appalling! What is happening to health care in our country when I a patient's life is not worth much? It is no wonder you have ptsd and its associated anxiety. I feel your pain very deeply and I am shocked at how your ablation turned into such a nightmare over some idiot's decision to freeze these records. Disgusting.
Deb
Deb
Deb; it outrages me too. When my files were sent to me by my attorney after my case against my insurance company was done; I saw the ER files I asked if he knew about it and he didn't and it wasn't in any of the files he sent to me.
He said it may or may not have made a difference; because multi focal pvc's aren't always dangerous but in my case they were; because each of my tests showed I had cardiomegaly (heart enlargement) which is one reason they suspected CHF at the ER along with my other symptoms and history.
I've talked to 2 attorneys about my case; one would take my case but I didn't like his terms in the fine print and I guess he thought he could take advantage of me because I was sick - came out to some crazy something like he got 75% of my settlement...the other attny said I don't have enough evidence.
Even with laws in the US that you can get your records; I've been told ultimately the doctor "owns" them who ordered them.
He said it may or may not have made a difference; because multi focal pvc's aren't always dangerous but in my case they were; because each of my tests showed I had cardiomegaly (heart enlargement) which is one reason they suspected CHF at the ER along with my other symptoms and history.
I've talked to 2 attorneys about my case; one would take my case but I didn't like his terms in the fine print and I guess he thought he could take advantage of me because I was sick - came out to some crazy something like he got 75% of my settlement...the other attny said I don't have enough evidence.
Even with laws in the US that you can get your records; I've been told ultimately the doctor "owns" them who ordered them.
That is so preposterous. My son, who is in law enforcement, tells me that they have to give you the records. I am going to ask him. He is just a deputy sheriff, but he knows a lot about the law. He asks for all his records and gets them, now I do the same.
Who told you that you can't get the records. That makes me furious. I think we are at the doctor's mercy as it is, but to think that they might be able to withhold records is unbelievable!!!
My first EP told me I have a less than 1% chance of dying from my v-tach. When I complained to my cardiologist that I didn't like that (How does he know?) he said that some doctors say that because if you die, then they can tell the family that they told you 1%, and then the family can't sue!!
Who told you that you can't get the records. That makes me furious. I think we are at the doctor's mercy as it is, but to think that they might be able to withhold records is unbelievable!!!
My first EP told me I have a less than 1% chance of dying from my v-tach. When I complained to my cardiologist that I didn't like that (How does he know?) he said that some doctors say that because if you die, then they can tell the family that they told you 1%, and then the family can't sue!!
You know, what is so ridiculous is the EP may not have suspected monomorphic VT and benign PVCs going into the ablation if he had had the records from the ER. Maybe it didn’t make a difference, but then again, maybe it did. It certainly sounds as if that info would have been important for the EP to know, plus the fact that they suspected congestive heart failure.
I’m glad you have the ICD. My husband got one about four years ago, and his has never gone off. At least that gives you some security now.
Thanks for the info about the ANS handbook. I will look into that. I need to research every angle so I can bring things up to the EP. My husband doesn’t do that. He tends to listen to the doctor and not look things up so much. I can tell by reading posts on this site that doctors are so often wrong about what they are suspecting when it comes to arrhythmias. That makes this condition maddening. I just hope I can get a diagnosis, but I am not holding my breath.
I’m glad you have the ICD. My husband got one about four years ago, and his has never gone off. At least that gives you some security now.
Thanks for the info about the ANS handbook. I will look into that. I need to research every angle so I can bring things up to the EP. My husband doesn’t do that. He tends to listen to the doctor and not look things up so much. I can tell by reading posts on this site that doctors are so often wrong about what they are suspecting when it comes to arrhythmias. That makes this condition maddening. I just hope I can get a diagnosis, but I am not holding my breath.
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