EKG changes with SSRIs

[andie3330]

I'm a 40 year old female in very good overall health. I have GAD and OCD. One of my biggest anxieties is with my cardiovascular health, although my all tests - EKG, stress echo, CT angiogram are normal with the exception of PVCs and PACs. I am trying to decide which SSRI has the lowest risk of causing EKG changes - specifically, which one is the least likely to prolong the QTc interval or increase the risk of ventricular arrythmias. I'm much more willing to accept the risk of other side effects, but I want to take the safest SSRI for my heart. Luvox was not effective for me and I had an allergic reaction (drug rash) to Zoloft. So now I'm trying to decide between Lexapro and Paxil. Based on the package inserts, it seems that Paxil may have less risk of prolonging QTc, but since I'm not a medical doctor (only a biologist) I may be missing part of the information and I don't have access to all the pertinent research. Would you recommend Lexapro or Paxil? My psychiatrist would be ok with either, but I haven't been able to make an appointment with him since I read the worrisome info about Lexapro prolonging QTc. But maybe Paxil has the same level of risk - I don't know.  Thank you so much for your valuable time spent in consideration of this question.

[Roger Gould, M.D.]

I have done some research for you, but you and your doctor should do more to be sure.  Almost all of the ssri's and related family of drugs have some qtc effect when used with other drugs  ( like methadone) and the research does not distinguish one from another. I think the best thing you can do is query the manufacturer of Paxil about their studies.....sorry, I don't know anything more, but I will ask around, and post on here if I find out any more....

[andie3330]

I forgot to mention, my only other med - that I have been taking for the last several months - is Xanax .5mg 3x/day. But I hope to be able to get off of the Xanax if a SSRI is effective for me. Thanks

[onroute]

I find these things worrisome as well but my husband and myself are deciding to pray and believe (with our hearts) the right direction.  I recently bought a book called "the Immune System Makeover" by Janet Maccaro..phD. Cnc and in that book she talking about herself praying and believe that the answers will come. She picked up books and other things (after she started to pray) which led her back to health. I think she prayed before she got sick and I have prayed but struggled with believing that God would acutally answer.  Anyway I took her for her word and tried this and my husband is now helping me  pray cause of the fact that I cant breathe with this disorder I have.  Breathing is a big thing when you think you are going to die, ones tries everything.  If it had been my big toe, I would not probably thought of praying but life in the balance with "air" was at stake.  Anyways, I feel I have gained  headway on this "praying" and my heart has really centred on the direction of the meds that the doc wants me on.  Sometimes I think (they) "doc" dont know they just guess and try anything and I confess my trust in doctors are somewhat shaky to say the least.  But I know that I know that I know (and I waited a long time for othe answer after my husband and I prayed and asked) but I belive that I heard in my heart and am solid in my decision...my psychologist has confirmed this as well.  Funny, when you hear the same thing from so many people (altho I dont follow what they say) it makes me realize that the God of the universe is speaking.  At least she says that in her book.

Hope this helps.  Cause only God knows for sure.  I suppose the doctors do to but as I said my faith in doctors is very skimpy..........

Another book that just got from pschologist which I love is called...."Women's bodies, Women's wisdom by Christiane Northrup, M.D.  She talks about inner wisdom (intuition) to get in touch with.  Not spooky or New Age stuff but what we feel if right inside.  Sometmes that is hard to get in touch with if been shut down all of our lives.  But book, I love.  She talks about meds and what they do or dont do and it is on every subject for women.  I will pray for you.

ps look on the internet for both books ,,,,I believe they are there.  Random House or Amazon...I think Amazom is cheaper.  Also Janet Maccaro has a web site to order.  Not that I am trying to tell what to do.  

[andie3330]

Thank you for considering my question. I wish it wasn't so difficult to compare the cardiovascular profiles of the different ssris - I know the data must be out there somewhere. When I talked to the Paxil rep, he said that the only ECG changes associated with Paxil occured when Paxil was combined with other drugs. On the other hand, Lexapro seems to effect QT interval as monotherapy. I made an appointment with my psychiatrist to dicuss this issue further. I know that I am probably overthinking what is probably an insignificant difference between the two meds - but if I need to take an SSRI, I just want to make the best choice with regard to cardiovascular profiles. Thank you again for checking into this for me - I really apprciate your time and effort.

[andie3330]

Thank you for your kind words and your prayers.  I try very hard to to control risk in my life - to the point were I am not able to fully live. I try to find the answers and to "know " as much as I can about anything that I percieve as "dangerous".  Truly though, we can't really "know" much of anything - but I think trusting God means being at peace with not knowing - not needing to know.  I'm trying, a little at a time, to give up my need to know and my need for control and to accept the fact that these are merely illusions - I can't really know or control the future at all.  So now I pray that God will give me the courage to let go of my illusions of control, and to trust that all is as God needs it to be.