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opinions on Lexapro and heart phobia induced anxiety

I been suffering with anxiety for many years.  From anxiety over skipped heart beats, to what felt like full blown SVT attacks.. It has ruined my quality of life overall..  I have learned to manage my symptoms over the years in a safe bubble in my house.. but have had a hard time driving, or leaving my comfort zone..  I never wanted to take medicine.. but i finally gave into the idea of trying a medication.  My doctor gave me 10mg lexapro.. and of course im worrying if this is a mistake.   I read things about SSRI's effecting the heart rhythm and stuff and thats the last thing i need.  I noticed an increase in my PVC's/PACs since starting lexapro.. Could be a coincidence cause i was getting them a little before i started taking the medication.. but lately i been getting at least one a day.  Sometimes 2 or 3 in a day.    the longest i went without getting one in recent times was over a month..  what are your views on lexapro?  Should I give it a try?  I am starting on 5mg going to see how i react on that before I raise the dose.. If i raise it im thinking of doing very small increases about 2.5mg each time.. I also eventually want to ween off that way as well... 2.5mg decrease every two weeks..  Is this a decent plan? Or do you think i should go on something like Buspar?   Maybe klonopin .25 taken very moderately with it.  

    some history ... I know i have anxiety.. couple years ago went to a cardiologist cause I SWORE I had svt.. My heart would take off like ridiculously fast..  it felt wayyy over 100bpm.. more like 200..  but I got ekg, echocardiogram, and a holter monitor where i had the attack actually on the monitor.. I was pretty convinced it wouldn't be normal.. but the cardiologist told me i had a panic attack.. That my heart was strong from the echo.. and that i didn't have one single Pac/Pvc on the holter monitor..  but the ekg said incomplete right bundle branch block that he thought so insignificant he didn't even mention it.  I asked him what that was, he just said its normal.   I also had a chest x ray back them when i had asthma, and an ekg at the lung doctors office.. and in the past ive had EKG's .. and never heard anything..  I thought once I got that SVT type thing caught on monitor that my anxiety would be 100 percent cured if i was told it was normal sinus tachy..  I think it helped because after that as time went on those symptoms decreased for awhile..  But they are never gone fully and I still am agoraphobic .. still scared .. still checking my pulse and obsessed with the idea that these symptoms can hit me at the worst times out of the blue..

Sorry for the long winded post.. just wanted any suggestions ..

best regards.

2 Responses
Avatar universal
The hard thing about anxiety is that sometimes it is caused by a trigger and sometimes it's not.  But when it is, it's episodic -- only that trigger is the problem.  In your case, if you've become agoraphobic, it's chronic.  While you may have noticed it because you wrongly believed you were having a heart problem that it appears you weren't actually having, a very common thing for anxiety sufferers, that seems for you to be just what you focused your anxiety on but the anxiety wouldn't have become free-floating if it wasn't already ready to break out.  The reason you weren't cured is because your heart worry wasn't the problem, the problem lies elsewhere -- possibly some deep insecurity caused by something that happened to you, possibly caused by depression, possibly caused by nothing anyone will ever figure out.  I'm wondering if, before you turned to medication and before it got this far along, did you ever seek out therapy with a psychologist who specializes in anxiety treatment such as CBT?  As for the Lexapro feelings, these meds do have side effects that differ by the individual, but because you express such a fear of going on medication I'd guess this particular symptom, given it's the same one you've had all along and not something new, is due to your anxiety over taking the medication.  You're probably not on a therapeutic dose yet -- 10mg is the usual dose for anxiety, though people differ in how much they actually need -- but you're tapering up on it is a very good idea and one your psychiatrist should have done -- this is pretty standard procedure with good psychiatrists.  If you're doing this with a general doc, since they don't specialize in this stuff, they don't really spend that much time learning how best and safely to use these meds, but your instinct was better than whatever doc you're using.  As for when you stop, that will depend on how long you end up being on the drug -- the longer, the longer the taper off will probably need to be.  There is no standard taper, though docs do get hooked on using the same one for everyone they see -- the taper depends on how the individual is reacting.  My own bias is for trying therapy before going on an invasive medication just as you would try physical therapy before getting surgery on your back, but if you're so far into this already that you're afraid to leave your house very often, you might already be at the point where medication is necessary.  Only trying therapy would tell you that, but it does take some time, whereas when mediation works it works in a shorter amount of time.  Also remember, the drug might not be the right one for you -- it can take time to find one that works.  As for Buspar, it doesn't have very good clinical results and is mostly used as an adjunct to an antidepressant.  Not to say it wouldn't help you, but it hasn't proven to work for very many people even in its own clinical trials.  As for benzos, if you take them regularly, they are addictive drugs, so they are better used only on an as-needed basis.  They are also hard to stop taking.  My own experience is that benzos are useful for when you have to do something that is hard for you to do, but when an antidepressant works, it works all the time.  Good luck whatever you try, and do consider therapy even if you do stay on the medication route -- drugs tamp down symptoms, but if you're one of the lucky ones who works hard and gets helped in therapy, you will be cured.  Again, be optimistic, and good luck.
Thank you for your thoughts and the feedback.  No i have not tried therapy yet, just read some books on it.  My general doctor gave me the medicine.  It is fortunate for the internet these days, can find out more information than the doctors know.   Everything I do with this drug I want to do it very slowly.  Right now I am on 5mg.. going to stay on that for awhile and then if  I go up in dose I rather just go up 2.5mg at a time.  I just want to avoid as many side effects as possible.
My personal advice is to get referred to a good psychiatrist (a lot of hacks out there so shop around).  It is what they specialize in.  But you figure this out on your own, which is great.  When I started out, doctors told us nothing and there was no other way to find out.  We just had to trust them, and that caused a lot of pain you won't have to go through.
I been on 5mg for two weeks .. I haven't noticed any positive effect... if anything i feel like i been getting more negative things .. like more skipped heart beats.. dizzy spells or whatever.. Things I have gotten before but they all seem to be happening a lot this month... Do you think i should go to 10mg, or gradually work my way up 2.5mg at a time?
I'd talk it over with your psychiatrist, but as for me, I'd probably go to ten and see what happens.  Tapering up doesn't need to be as gradual as tapering off.
Ok thanks.  I appreciate the advice.. i guess i am just scared of lexapro negatively is impacting me or the heart or something.  
It might be -- that's why I'd discuss it with your psychiatrist.  A lot of anxious people think they're having heart problems no matter how many times they've been told they're not, but I don't know if that applies to you.  But you're not yet on a therapeutic dose of Lexapro so you really don't know if it'll work or not yet.  If it works really well, you probably won't notice the side effects as much as you would if it doesn't.
Yeah i went to a cardiologist a couple of years ago and got one of these crazy heart racing events captured on a monitor and was told it was a panic attack.. I find it hard to believe sometimes.. The heart just goes insane like its in some kind of weird mode.. I was pretty convinced i was having SVT episodes or something.
20003388 tn?1515166040
I have been on SSRI medications for 22 years. I have pretty much been on every SSRI on the market. Starting a medication can be scary, especially if you have anxiety issues and reading about side effects can make things 1000x worse. The meds really are quite safe. I've never had heart issues with any of them (even when I felt I was having issues with my heart). SSRI's, including lexapro, are very safe and very effective for a lot of people. I, personally have been on lexapro and for me, at the time, it was a life saver. Don't let your fear prevent you from trying the lexapro out. I know that is easier said than done but you may find it eases your overall anxiety which could very well help with your cardiophobia. I also have cardiophobia. For a long time I was checking my heart rate 15-20 times a day. I would totally freak if my heart rate went over 100 which it was 99% of the time. The reason it was so high was because of anxiety. The more I checked my heart rate the more anxiety I got which just made my heart rate go even higher. One type of medication I found helpful were beta blockers. I was on Atenolol for a long time with my paxil. When my heart rate got too high I would take a quarter or a half of my 25 mg pill and it would drop my heart rate into the mid to high 80's which greatly eased my anxiety. Beta blockers are pretty commonly prescribe for the physical symptoms of anxiety. They do have side effects and you do have to be a somewhat cautious but that may be something to look into to add to your lexapro. Anxiety is a funny thing. It can make you feel like something is wrong even to the point where you actually feel physical symptoms. Maybe lexapro will help you, maybe it won't. If it doesn't there are other SSRI's that may help you. I would personally avoid paxil. It works well but you may gain a ton of weight on it. I was recently switched from paxil to prozac and it was the best decision. You could try buspar but it's kind of a funny medication. It either works or it doesn't. It seems about 50% of people it doesn't work for and 50% of people it does. If it does work it can be a fantastic add on to an SSRI. You could also add on something like abilify or rexulti. There are tons of medication combinations that could ease your symptoms. A beta blocker might be a good place to start to give you a little peace of mind about your heart. Sorry for the long winded reply but I hope that something I said is of benefit to you. It sounds like you and I have a lot in common with our symptoms so I can relate. Trust me, with the right medication it will get better. You could even finally be able to live a normal life without having to worry all the time. Be strong and I wish you luck.
Agree that many people are helped by meds.  Don't agree they are "quite safe."  No pharmaceutical products are at all safe, though some are safer than others.  When we need them we need them, I take them, but people do need to know what they're getting into.  In your case, you will most likely never be able to stop taking these meds whether you ever needed them or not in the first place because you're brain will probably no longer work without them.  Taking beta blockers when you don't have a heart problem can create one, because your body can become dependent on them.  This is true with any drug you use for a long time -- your body can forget how to operate naturally.  And they are very hard to stop taking, and for some, including me, that stoppage can create permanent damage.  Now, are they safer than a lot of other drugs?  Yes.  But quite safe?  That makes it too easy for people and too many doctors too quick to turn to medication without first exhausting attempts to solve the problem without medication.  We keep forgetting, part of the medical dogma is, first, do no harm.  Since all medications make the body operate in artificial ways, they all have problems for some people.  It's great if you're not one of those people.  It's not so much fun if you are.  But I still agree, if you need them, you need them, and at the point you make that decision, there's no point in dwelling on the downsides anymore than there would be if you needed medication because you couldn't control your blood pressure any other way.  Peace.
I should add, Buspar does not help 50% of the people who take it.  None of these drugs do -- the best work about 30% of the time, which is why there are so many of them on the market.  Clinical trials don't have to be that successful to get a drug patented and approved for use, they just have to be better than placebo.  But Buspar has never done well in clinical trials, it didn't even hit that level.  This drug has been trying to find an ailment it successfully treats for decades.  Right now, it's mostly used as an adjunct drug to an ssri.  Doesn't mean it doesn't help anyone, just that at least in scientific testing it hasn't done all that well.
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