Fluvoxamine, fluoxetine and paroxetine are considered lower risk antidepressants with minimal effects on the cardiovascular system. Fluoxetine is contraindicated with metoprolol and paroxetine may increase cholesterol levels. Citalopram causes dose dependent QT interval prolongation and is generally avoided in CHD.
Citalopram or Sertraline have been suggested to be the first-choice antidepressant agents for patients with CAD. In addition to these two SSRIs, Fluoxetine is recommended to be used in improving post-myocardial infarction depression.
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.
Some Harmful Antidepressants
Tricyclics, such as Elavil (amitriptyline), may cause dizziness and elevated heart rate. Monoamine Oxidase Inhibitors (MAOIs), which include Nardil (phenelzine), can cause irregular heartbeat and sharply elevated blood pressure when paired with certain foods.
No evidence that SSRI users were at a higher risk of developing acute heart disease but significant between-study heterogenicity was observed. There was 29% increased risk of acute heart disease found for using TCAs.
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.
Zoloft (sertraline) can affect the natural rhythm of your heart and cause it to beat abnormally. If you experience symptoms such as fast heart rate, dizziness, difficulty breathing or chest pain, go to the emergency room right away.
The drugs used to treat depression by affecting the brain's use of the chemical serotonin -- Prozac, Paxil, Zoloft -- also tend to reduce the abnormalities in heart rhythm and blood clotting. For cardiac patients, these antidepressants may act primarily as blood thinners, a complicated form of baby aspirin.
Patients taking Lexapro also tended to have healthy changes in heart function and they reported feeling calmer and more controlled than the placebo group. "Our findings support the hypothesis that short-term use of SSRIs improves levels of biomarkers associated with adverse cardiovascular outcomes," explained Jiang.
Cautions for specific antidepressants
a bleeding disorder. type 1 diabetes or type 2 diabetes. epilepsy – SSRIs should only be taken if your epilepsy is well controlled, and the medicine should be stopped if your epilepsy gets worse. kidney disease.
High doses of the antidepressants citalopram (Celexa) and escitalopram (Cipralex, Lexapro) do not appear to carry greater risk of sudden cardiac death than comparable doses of other selective serotonin reuptake inhibitors, according to a new study.
What are the most common antidepressants? Sertraline hydrochloride, used for multiple mental health and mood disorders, is the most prescribed antidepressant on the list with more than 18 million prescriptions in 2021.
Sertraline may be the best first-line antidepressant for patients at risk for QT prolongation. Higher doses of citalopram may be appropriate in some patients with careful selection and judicious monitoring.
The norepinephrine–serotonin modulators, mirtazapine and mianserin, have minimal effects on blood pressure but may rarely lead to orthostatic hypotension and falls.
Regarding AD, our findings have shown that Zoloft® (sertraline), Trevilor® (venlafaxine), and Anafranil® (clomipramine) appear to be critical substances concerning the risk of cardiac arrhythmias.
The study found that neither current nor recent users were at increased risk of AF. This again indicates that antidepressants are unlikely to directly predispose to AF.
dizziness. weight gain. excessive sweating (especially at night) heart rhythm problems (arrhythmia), such as noticeable palpitations or a fast heartbeat (tachycardia)
Calcium channel blockers such as verapamil and diltiazem work in a similar way. Digoxin is also commonly prescribed for AF to help control the rate. Flecainide, sotalol (also a beta blocker) and amiodarone are also commonly prescribed for arrhythmias.
A cardiologist sensitive to the issues of anxiety and depression will know how to sort out panic attack symptoms from heart attack symptoms, and will be able to refer the patient for treatment for panic disorder or any other type of anxiety.
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.