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SSRIs and heart changes


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I was reading about this thing called Sudden Adult Death Syndrome and one of the possible causes is Long QT Syndrome.  Long QT Syndrome can cause an arrhythmia called torsades de pointes which is sometimes deadly.

I remember reading in the Lexapro PI sheet that the drug increases the QTc interval but claims that it is not a clinically significant change.  Fluoxetine (Prozac) is listed as a "drug to avoid" on an Adult Death Syndrome advocacy website, so I assume Lexapro falls under that too, but avoided by whom I don't know.  My question is does anyone have any idea how often these kinds of serious arrhythmias occur on SSRIs?  One article claims that some drugs induce this arrythmia in as high as 2-3% of takers.

Oh yeah, another thing in the PI sheet said that 5 of 10 dogs in a study died suddenly because of QT interval prolongation! 

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ah, here we go, from www.torsades.org

"Drugs Unlikely to Cause Torsades de Pointes

Drugs that, in some reports, have been weakly associated with Torsades de Pointes and/or QT prolongation but that are unlikely to be a risk for Torsades de Pointes when used in usual recommended dosages and in patients without other risk factors (e.g., concomitant QT prolonging drugs, bradycardia, electrolyte disturbances, congenital long QT syndrome, concomitant drugs that inhibit metabolism).

Elavil

Celexa (close enough probably)

Anafranil

Sinequan

Prozac

Sarafem

Pamelor

Paxil

Vivactil

Zoloft"

The only psychiatric drugs that are definitely associated with it are some old-school antipsychotics.

That dog thing is just scary, though.

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I have heard antidotal stories of this happening to people, and have seen EKGs of people wtih weird heart beat patterns, mainly due to discontinuation of an SSRI. All of them have withdrawl symptoms, some worse than others (Paxil has been kicking my ass for YEARS), but having heart beat weirdness can come with the territory I'm told.

Discuss with your pdoc and see an MD, and tell him/her about your issues. They can do an EKG and stress test, and rule out heart issues. Then it is all in your mind, this anxiety and other things that can complicate heart issues. I am assuming that you do not have heart problems and are an otherwise healthy person just having weird issues due to the SSRI.

Best of wishes

Melinda aka Loon

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