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Mental Health (Expert Forum)
Arrythmia Problems Related to SSRI/SNRI Medications?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Arrythmia Problems Related to SSRI/SNRI Medications?
by RickT, Jan 18, 2002 12:00AM
I'm a 54 year-old male. I've been pretty athletic for the past 25 years. I'm almost a non-smoker (2-3 cigars per month) and a moderate coffee (2 cups per day) and alcohol (2-3 drinks on weekends) consumer. I'm by nature an anxiety/worry prone person. September 11th really did an emotional number on me, to the point that I visited a psychologist and my Primary Care doc. The latter person put me on 50mg of Zoloft and a small daily dose of Aciphex (for mild reflux) around the end of September. Around the holidays in December, I started having heart arrythmia (an average of 1-3 "skipped beats" per minute). I also wasn't happy with the sexual side effects of the Zoloft. My doctor switched me from the SSRI to an SNRI (Serzone), slowly working up to 200 mg twice a day (morning and evening). She also referred me to a local heart clinic. They gave me a stress test, 24-hour holter monitor, and some sort of imaging (X-Ray? Ultrasound?) of my heart. I passed the tests with no problems, except for a "regular rate and rhythm with occasional PAC'S (irregular beats from the top part of your heart)" comment on a form I got in the mail with the holter results summary. I have noticed that with the use of the antidepressants (I suspect), my normally low resting heart rate (in the morning when I awake) went from 55 to 47 beats per minute. Could either the cumulative effects of the SSRI (2-1/2 months) and then the SNRI (since mid-December) along with the aciphex be causing these? I can still run 2-3 miles with no discomfort, but I'm still having the missed beats. (They may even be increasing.)
Doctor's Answer
by Roger Gould, M.D., Jan 18, 2002 12:00AM
, Jan 18, 2002 12:00AM
ssri's and snri's can definitely cause irregular beats and cardiac irritability. The question is the seriousness or acceptability of this symptom, and only you and your doctor can determine that. You might try, with supervision, lowering the dose and see what happens. There are other medications to counteract this, but it brings in too many elements to manage from my p.o.v.
