Antideppressants & fatal heart arrhythmia??

September 27, 2006 9:28 PM

Link between antideppressants & fatal heart arrhythmia??

I have been taking a very small dose of Celexa for years. Every time I go off of it I start to feel depressed and very anxious.

I've also had some near-fainting spells where my pulse becomes irregular (usually it's extremely faint) and feel extremely weak and sometimes clammy.

I've had a stress test and a neurological exam and no cause could be traced. My doc has theorized that it could be vaso vagal syncope (a harmless condition that can cause fainting).

New reports say that Anna Nicole Smith's son died from an apparent arrythmia brought on by a combination of antidepressants, including Lexapro (a cousin to Celexa). This has really got me concerned because I've always worried in the back of my mind that what I've been experiencing is an arrhythmia. It's very scary to have these spells because I feel like I'm going to pass out. Young (>30) healthy people shouldn't be passing out regularly, should they?

I don't expect medical advice on here, but please, if any of you have had similar issues and/or you know about the risk of arrhythmia from celexa, and how dangerous it is likely to be, please let me know. I also sometime drink to excess when I'm taking this medication. I know I shouldn't, but I do.

posted by mintchip to health & fitness (7 comments total)

When you went to the doctor, did she actually detect an arrhythmia? What may feel like a "fatal arrhythmia" could be stress or anxiety--you could be throwing PAC's or PVC's (premature atrial and ventricular contractions) caused by stress. If you are young and healthy, this is probably what is happening. I am not a doctor, so take my advice with a grain of salt. I am an RN, that has worked with hearts for nearly 10 years. If your doctor was concerned about an arrythmia you should of probably been sent home or admitted with a 24 hour Holter monitor.

I would keep with your prescribed dose until your doctor or the FDA instructs otherwise. I would also read the Celexa insert carefully and discuss side-effects with your doctor. Maybe she can alleviate some of your fears. Good luck.
posted by LoriFLA at 10:13 PM on September 27, 2006

You've had near fainting spells and irregular pulse with clamminess and weakness while coming off the med? Might just be typical withdrawal problems.

If you have these symptoms while on the drug, I'd probably try switching. There are several effective antidepressants that differ slightly in side effect profiles. Whatever is happening, you're not comfortable with your med anymore and there are alternatives.

I've prescribed this quite a bit and haven't come across true heart problems in my patients, nor have I read about a significant number of people with this. Long QT syndrome occurs in less than 1% and this itself leads to a bad arrhythmia in a very small minority of cases.

Now you've had a stress test and a neuro eval (while you're on the med?), it seems to me the risk of the medication is probably acceptable.
posted by Slarty Bartfast at 10:18 PM on September 27, 2006

According to this report, he was taking Zoloft, Lexapro, and Methadone.

Methadone is a synthetic opiate used to treat heroin addiction.

It appears that it was the combination of drugs which killed him, and you're not taking the same combination of drugs. Drug interactions are not what you think because they have emergent properties: the combination can have pharmacological effects not produced by any of the component drugs when taken individually.
posted by Steven C. Den Beste at 10:40 PM on September 27, 2006

It is good to be critical of medication, as there is plenty that is still unknown about most psychopharms, but one needs to do so in a way that is rational. Drug interaction is probably what killed the person in question, just as SCDB indicated. As well, if you are experienceing the syptoms when you stop taking the meds it is the withdrawal that is causing your reactions. This is why when people discontinue such medications they gradually cut back, as opposed to going cold turkey.
posted by edgeways at 9:58 AM on September 28, 2006

Why are you going off the medication at all? Are you doing it under a doctor's care? If you are on Celexa, you should *never* just stop taking it.

What does your doctor say about the symptoms?

I'm kind of getting the idea that you and your doc aren't communicating. This is the real problem.
posted by shifafa at 11:59 AM on September 28, 2006

Just a note of empathy, I have anxiety too (treating with Cymbalta) and experience the same feeling of a racing pulse when I'm anxious or missed my meds for a day or two.

I had the same problem before I started taking the medication, too. I also tend to feel flushed or feverish, and for a while carried a thermometer with me everywhere I went (my temperature always turned out to be normal).

Now I've learned that if I'm starting to take my pulse, it's a sign that I'm getting anxious, and I need to either take a Xanax, or focus on calming myself down.
posted by el-gregorio at 12:00 PM on September 28, 2006

I'm not a doctor, so I'll try to keep this as anecdotal as possible:

I had some scary episodes of what seemed like serious cardiac problems--it seemed like my heart was not pumping regularly. In the end, it turned out that I had developed anxiety about my cardiac health. Anxiety sounds like some minor condition, but it is very real and can be severely debilitating. The symptoms are disturbingly close to cardiac distress (nervousness, sweating, dizziness. rapid weak pulse; however, see below).

My experience somewhat mirrors el-gregorio's, but I was more obsessed with my heart rate. Getting in better shape helped (when your resting HR is always < 80, you're more likely to perceive that a 'skipped beat' here and there is not some indication of cardiopathy). Other than that, just realizing that you're becoming anxious (a la el-grigorio's suggestion) may be a big help.

One good thing to remember: if your heart is actually in trouble in some sort of ischemic way (i.e. like a heart attack), it tends to hurt pretty damn bad. Never in my experience did I have any pain at all--it was always just a scared feeling.

Good luck, and hope you feel better soon.
posted by oats at 7:31 PM on September 28, 2006