Within the tricyclic and tetracyclic categories of antidepressants, Imipramine, Amitriptyline, Nortriptyline, Desipramine, Maprotiline, and Doxepin may cause considerable QTc prolongation, while the administration of Clomipramine, Mirtazapine, and Trazodone lead to a mild prolongation.
SSRIs are the most common form of antidepressants but other forms of the medication are available, such as mirtazapine, venlafaxine, duloxetine and trazodone. For these types of treatment, the risk of death from any cause more than doubled while the risk of heart disease increased by 86 per cent.
Selective Serotonin Re-uptake Inhibitors (SSRIs) and Mirtazapine. SSRIs are the preferred antidepressants in CHD. Sertraline, fluoxetine, or paroxetine are the SSRIs of choice. Mirtazapine is also a preferred antidepressant in CHD.
Certain medicines used to treat depression can raise your heart rate. They include serotonin and norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine, duloxetine, and venlafaxine, and tricyclic antidepressants such as amitriptyline, clomipramine, desipramine, and others.
The cardiac adverse effect profile of antidepressants ranges from hypotension, hypertension (HTN), bradycardia, tachycardia, electrolyte imbalances, ECG abnormalities, reduced cardiac conduction and output, arrhythmias, and SCD [7].
The researchers emphasized that no one with a history of arrhythmias should start taking these medications. Instead, such a patient might try one of the antidepressants that do not increase the Q-T interval: fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), or buproprion (Wellbutrin).
Can I take antidepressants if I have a heart condition? Yes, but you will have to take the right one, depending on the nature of your heart condition. For example, tricyclics are contraindicated (can not be prescribed by your doctor) during the recovery period following a heart attack.
Propranolol belongs to a group of medicines called beta blockers. It's used to treat heart problems, help with anxiety and prevent migraines.
When looking at individual cardiac events, the researchers found a significant reduction in the occurrence of heart attacks: 8.7 percent of patients in the escitalopram group had a heart attack compared with 15.2 percent in the placebo group, a greater than 40 percent reduction.
Selective serotonin reuptake inhibitors (SSRIs).
Health care providers often start by prescribing an SSRI . These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants.
SSRIs are usually the first choice medicine for depression because they generally have fewer side effects than most other types of antidepressant.
Overall, citalopram appears to be the best-tolerated SSRI, followed by fluoxetine, sertraline, paroxetine, and fluvoxamine. The latter 2 drugs are associated with the most side effects and the highest discontinuation rates because of side effects in clinical trials.
Tricyclic antidepressants (TCAs)
TCAs are an older type of antidepressant. They're no longer usually recommended as the first treatment for depression because they can be more dangerous if an overdose is taken. They also cause more unpleasant side effects than SSRIs and SNRIs.
Serotonin is known to escalate the heart rate, increase the contraction forces of the heart chambers, alter the heart rhythm, and cause obstruction in the coronary artery. It has been thoroughly studied that serotonin causes certain cardiac events that hamper the heart's normal function.
Stress, exercise, medication or, rarely, a medical condition can trigger them. Although heart palpitations can be worrisome, they're usually harmless. Rarely, heart palpitations can be a symptom of a more serious heart condition, such as an irregular heartbeat (arrhythmia), that might require treatment.
New-onset AF has been associated with cardiovascular drugs such as adenosine, dobutamine, and milrinone. In addition, medications such as corticosteroids, ondansetron, and antineoplastic agents such as paclitaxel, mitoxantrone, and anthracyclines have been reported to induce AF.
Palpitations are characterized as a general or heightened awareness of your own heartbeat – whether it's too fast, too slow, or otherwise irregular. You might feel like your heart is thumping, racing, or fluttering. And you could feel this sensation in your chest or your neck.
The difference is that, when extra heartbeats in the upper and lower chambers are the cause of abnormal rhythm, symptoms may feel like an initial skip or hard thumping beat followed by a racing heart. When anxiety is the trigger, heart rate typically increases steadily rather than suddenly.
Increased blood pressure – Stress and anxiety cause cortisol levels to spike which increases blood pressure and heart rate. Frequent spikes in blood pressure weaken the heart muscle and could eventually lead to coronary disease.
The short answer is yes. According to multiple studies, anxiety increases the risk of developing heart disease and having a heart attack or stroke. Anxiety is a group of mental health disorders, including generalized anxiety disorder, panic disorders, and post-traumatic stress disorder (PTSD).
SSRIs are the most commonly prescribed class of antidepressants. This is because they're effective and well-tolerated antidepressants with little side effects. With many SSRIs available as generic products, this medication class typically costs less. SNRIs and bupropion are also common choices for similar reasons.
Neurologists prescribe antidepressants to treat depression in neurological patients, chronic pain syndromes and neuropathic pain, panic attacks, eating disorders, premenstrual syndrome and for migraine prevention.
Avoid taking
These include: ibuprofen, Advil, Motrin, Aleve, Toradol, Celebrex. These medicines hold fluid and cause swelling. They also can harm your kidneys. Cold and cough medicines with pseudoephedrine or phenylephrine.