Beta blocker vs SSRI

Question

Hi!

Just wanted to share my experience with the different medications.

Two and a half years ago, I started taking beta blockers (20 mg propranolol + 25 mg metoprolol slow release) to treat PACs, sinus tachycardia and atrial tachycardia caused by stress and anxiety.

Five months ago, my anxiety switched from heart rhythm/heart issues onto a new and probably even more troublesome subject. I now know that my heart anxiety in fact was a manifestation of OCD, with clear obsessions and compulsions (checking pulse, blood pressure, taking EKGs, learning all about heart rhythm). My OCD is now more harm related (fear of harming myself, fear of harming my girlfriend, etc.)

So, I realized that I needed some more powerful treatment. Started taking Zoloft, and my doctor told me that I could quit taking beta blockers whenever I wanted to.

One month ago, I stopped taking propranolol. My anxiety didn't get any worse, but it somehow felt more like anxiety (as I got more physical symptoms of anxiety which the propranolol somehow stopped). It was OK. Good to know that I in fact suffered from anxiety and not some other mental illness or heart disease. Recently I stopped taking Metoprolol too. I still feel fine. The anxiety is there, but it doesn't bother me so much.

So it seems like SSRI can be a great alternative for those suffering from anxiety. Just wanted to mention.

:)

gothic_beauty · Accepted Answer

I really enjoyed reading about your experiences, because I continue to debate the merits of SSRIs versus beta blockers in dealing with anxiety-induced arrhythmia. As I know you know, I suffer from anxiety that causes my heart to beat extremely rapidly, and occasionally to skip beats. For a long time, I was convinced that a beta blocker was the only thing that could help me. If my heart is going too fast, what better cure than a medication specifically designed to slow the heart? However, my doctor was reluctant to prescribe beta blockers, wanting to focus on the cause of the symptom (the anxiety) rather than the symptom itself (the arrhythmia.) She said that if the cause is dealt with, then the symptom will go away. However, if the cause remains valid, the symptom can always manifest itself, even if it is being treated separately. My cardiologist felt the same way. He likened the situation to a leaky faucet, suggesting that alleviating my symptoms with beta blockers would be like laying out a lot of towels on the ground to soak up dripping water, while treating my anxiety, whether by lifestyle changes or anxiety meds, would be like replacing the faucet itself. Needless to say, the more logical solution is to replace the faucet. That made a lot of sense to me, and instead of pushing for a beta blocker, I chose to start an SSRI medication to reduce my anxiety. I've been on 20 mg of Lexapro for almost four months now, and I am loving it.

Although it took about six weeks before I started to feel the effects of the medication, I am now calmer than I have been in years. Situations that used to terrify me I am now able to face head-on. Anxious thoughts no longer torment me at all hours of day and night. Even when I do become anxious, the anxiety doesn't seem quite so insurmountable. It's as if its blade was dulled so that it can no longer pierce my skin. 

That being said, I do experience bad episodes of anxiety on rare occasions, and these instances can lead to racing heartbeat and irregular pulse that cause me to wonder if I should request a beta blocker to take on an as-needed basis. On the other hand, I am more aware than ever that my difficulties are caused by my mind, not my heart, and I don't want to try to alter the natural rhythms of my heart when I should be focused on my mind. I am glad that there are others who can testify that the heart can be pacified without being directly forced into obedience. It reinforces in my mind that I have made the right choice, and that my heart is going to continue to beat happily for many years to come! 

Thanks for posting and keep us updated ...

is_something_wrong · Answer

Thanks guys, you are great!

Of course, with "real" heart problems, SSRIs don't work. 

Beta blockers are in my case great to use if needed. They can help if my anxiety is very high for some reason. But it feels great not having to take them permanently.

Jerry_NJ · Answer

I got around to looking up OCD:  Obsessive–compulsive disorder.

Will I'm sure I have some anxiety, a growing anxiety with advancing age, I don't connect it in any way with my AFib problem.  I have never taken any medication specifically for anxiety but I have many years on beta blockers which I believe cause me some fatigue problems, maybe add to a dreaming problem.

I'll step back to read only on this post.

achillea · Answer

Your experience is very similar to mine:  With an essentially healthy heart, I have found certain SSRIs (zoloft, especially) to be very  effective in reducing my hyper-awareness of ectopics--and without the side effects that beta blockers can produce!

Jerry_NJ · Answer

Happy to read you are making progress, but admit I (and perhaps others) don't know what OCD is (a quick search on Medhelp didn't help).

You may have connected yourself with anxiety in the past, but I missed it, or forgot it.

Thankfully my experience with any noticeable level of anxiety didn't show up until I entered my senior (golden?) years.  I had heard it said:  "growing old ain't for sissies", guess I'm a sissy. 

As for BB and CCB in my case, I need them to lower HR so I don't think I can translate your experience to my situation - or did I overlook?

Happy New Year.

Beta blocker vs SSRI

Bigeminy Heart Beat 44% of the time

Safe Blood Pressure on Metoprolol Succinate

Pvcs and low heart rate

How do I know who is right?

Bigeminy Heart Beat 44% of the time

Safe Blood Pressure on Metoprolol Succinate

Pvcs and low heart rate

How do I know who is right?

You are reading content posted in the Heart Rhythm Community