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Antidepressant Tied To Dangerous Heart Rhythm, Fda Says

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Antidepressant Tied to Dangerous Heart Rhythm, FDA Says

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WEDNESDAY, Aug. 24 (HealthDay News)

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I am on 40 mg a day of Celexa and have had no problems with heart rate. However, when I was on Elavil (which really helped my depression) I did have problems with heart palpatations. I wonder if all Ads increase heart rate to a degree?

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I am on 40 mg a day of Celexa and have had no problems with heart rate. However, when I was on Elavil (which really helped my depression) I did have problems with heart palpatations. I wonder if all Ads increase heart rate to a degree?

I was on celexa in the past for 2 1/2 years. It helped me a lot! However, I was stupid and I quit cold turkey. Now that I tried to go back on it, it didn't work at all.

But back to the heart issue, when I was on it there were several times I woke up in the middle of the night and my heart felt like it was going to jump out of my chest. My whole body was shaking. This feeling lasted for 15-25 seconds. It was not a panic attack.

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The actual FDA release:

Celexa (citalopram hydrobromide): Drug Safety Communication - Abnormal Heart Rhythms Associated With High Doses

[Posted 08/24/2011]

AUDIENCE: Psychiatry, Cardiology

ISSUE: FDA notified healthcare professionals and patients that the antidepressant Celexa (citalopram hydrobromide) should no longer be used at doses greater than 40 mg per day because it can cause abnormal changes in the electrical activity of the heart. Changes in the electrical activity of the heart (prolongation of the QT interval of the electrocardiogram [ECG]) can lead to an abnormal heart rhythm (including Torsade de Pointes), which can be fatal. Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium in the blood.

Studies did not show a benefit in the treatment of depression at doses higher than 40 mg per day. Previously, the citalopram drug label stated that certain patients may require a dose of 60 mg per day. The citalopram drug label has been revised to include the new drug dosage and usage recommendations, as well as information about the potential for QT interval prolongation and Torsade de Pointes. See the FDA Drug Safety Communication Data Summary for additional information.

BACKGROUND: Celexa (citalopram hydrobromide) is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs).

RECOMMENDATION: Citalopram causes dose-dependent QT interval prolongation. Citalopram should no longer be prescribed at doses greater than 40 mg per day. Citalopram should not be used in patients with congenital long QT syndrome. Patients with congestive heart failure, bradyarrhythmias, or predisposition to hypokalemia or hypomagnesemia because of concomitant illness or drugs, are at higher risk of developing Torsade de Pointes. See the FDA Drug Safety Communication for additional recommendations for healthcare professionals and patients.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

[08/24/2011 - Drug Safety Communication - FDA]

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I am new to the group but am glad I am here. I am and have been on for months now 80mg of Celexa once a day. I have anxiety, depression and OCD. I saw my psychiatrist this morning and he wants to wait to switch ANYTHING until my EKG tomorrow AFTERNOON! I am a WRECK. my anxiety is through the roof, I am feeling chest pains but dont know if it is my anxiety or if it is reality. Or what is going on. I just am scared. I am a single mom of two little kids and I dont like being on meds but I know that they have helped me. I see people saying 60mg is too high and I am on 80mg. I want to not take it tomorrow but I know my dr said to wait until after the EKG....but I am REALLY a wreck. I panic (my anxiety is mainly based on) medical things going wrong or happening to me, unreasonable or not so hearing this has me very scared. Anyone care to comment?

Thank you all,

Lisa

Antidepressant Tied to Dangerous Heart Rhythm, FDA Says

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WEDNESDAY, Aug. 24 (HealthDay News)

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Hi. Just try to wait for the test results. Not everyone is affected by thus. It can affect the electrical activity of the heart. It doesn't mean you would necessarily have to stop taking it. Your doc may decide to lower your dose. I take 20mg of Celexa and will go up to 40 if needed. Try to wait for the results and then take it from there. Let us know how it goes.

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I was having irregular heart beat problems about 2 weeks ago on 20 mg. That was the first time I experience this. It's It fun...

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What about Escitalopram? It is made from the same chemical as Citalopram, so there should be the same risk?

I've been on Escitalopram 10mg for 5 months but had to reduce it to 5mg because of the heart rhythm problems which I had.

I thought it was just palpitations but this report by the FDA makes me wonder what was going on. Thankfully, the palpitations are minimal now that I am on a lower dose.

But the depression is worse. I have to struggle with it. Must try to get more exercise.

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i have qt interval prolongation syndrome (heart arymythia, fast heart rythum) which was drug induced caused originally by venzaflaxine last year, i was put back onto citalopram 40 mg, was stressed and asked for it to be put up to 60 mg after a ecg reading my qt interval was at a dangerous level again, so i have has to reduce to 40mg, and am waiting of qt to go back down. This is now a dangerous drug i have taken this on & off for eight years, but i need off this now also. I am now under a cardiologist because of this also. If you need a high dose please stay off venzaflaxine ans citalopram,

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Hi new gal on the scene. I was born with Essential Tremors, left arm/hand always shaking. Got kidded and teased alot. Grew up and went away but now as I approached my 40's they are back. My doctor put me on Xanax 1 mg 2 x day. It has saved my life! I've now been on Xanax 2 mg a day for over 22 years now and wouldn't live without it. I also suffered with very bad panic attacks (oh the hospital bills!), but Xanax helped them too, along with some therapy. I have been put on many many anti-depressants in my life. Low dose high dose. But I was one of those when I felt better I stopped them. Screwed up my system. Finally got on Celexa (generic) @ 20 mg. Have been that way for 4 years along with Xanax, my breakfast when I wake up. Tried increasing another 10 mg and have noticed strong heart palpitations. Will go back to 20 mg and eventually change over when I have insurance money. So yes to NOT increasing my celexa to 30 due to heart palps.

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Im confused.

My doctor said Celexa over 40 mg is only dangerous to certain people who have pre-existing cardiac conditions.

He said it would only be a risk to about 1% of people who take it.

Is this accurate? Or is it a higher risk to everyone?

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I realize that some of these posts are dated, but I wish to reply to them.

Im confused.

My doctor said Celexa over 40 mg is only dangerous to certain people who have pre-existing cardiac conditions.

He said it would only be a risk to about 1% of people who take it.

Is this accurate? Or is it a higher risk to everyone?

Citalopram (Celexa) can increase the QT interval based on a dose-dependent manner. Here is some information on Long QT Syndrome that mentions other risk factors.

A small increase in QT interval (in an otherwise healthy person) does not automatically equate to a life threatening arrhythmia. Many things can cause an increase in the QT interval.

People with pre-existing heart conditions who are on medication (or multiple medications) that increase QT interval can have a higher chance of having an arrhythmia.

I am on 40 mg a day of Celexa and have had no problems with heart rate. However, when I was on Elavil (which really helped my depression) I did have problems with heart palpatations. I wonder if all Ads increase heart rate to a degree?

Different classes of AD's have different side effect profiles depending on the type of neurotransmitters that they work on (serotonin, dopamine, norepinephrine, etc).

As a general rule, the AD classes that are associated with cardiac side effects are those change levels of norepinephrine. These class of medications include:

-Serotonin-Norepinephrine Reuptake Inhibitors

-Tricyclic Antidepressants

-Norepinephrine reuptake inhibitors

-Norepinephrine-Dopamine Reuptake Inhibitors

-Norepinephrine-Dopamine Releasing Agents

-Monoamine oxidase inhibitors

What about Escitalopram? It is made from the same chemical as Citalopram, so there should be the same risk?

I've been on Escitalopram 10mg for 5 months but had to reduce it to 5mg because of the heart rhythm problems which I had.

I thought it was just palpitations but this report by the FDA makes me wonder what was going on. Thankfully, the palpitations are minimal now that I am on a lower dose.

But the depression is worse. I have to struggle with it. Must try to get more exercise.

Escitalopram (Lexapro) is the S-enantiomer of citalopram (Celexa; a racemate). I'm unaware what effects escitalopram have on the QT interval (whether the effects seen in Celexa on QT are due to one or both the R and S enantiomers of the drug).

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I am on 40mg of citalopram a day at the moment. I knew they had stopped giving out 60mg because I had a friend that went through this. But I feel like my heart races for no reason sometimes, too.

I was afraid it was because I'm slightly "overweight" (they say I should be 60 pounds skinnier but I enjoy having some meat on my bones, tyvm!), but I guess maybe it's this? I was about to meet with my doc about changing meds anyway but this gives me a much greater reason.

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OMG, this is my first day on 10mg now I'm freaked out after reading this

Sent from my SCH-I605

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Hi,

I've been on 20mg Cipralex for about 2 years. Then I weaned myself off it, because I was feeling lots better. Then after going to 5mg a day my heart palputations started. I went for 48hr ecg and the cardiologist said my heart is fine but the electrical impulses sent to my heart is the problem and he can prescribe some betablockers. I thought my irregular heartbeats had something to do with weaning off the Cipralex. My psychiatrist said the heartbeats was my anxiety starting again (eventhough I didn't feel depressed or anxious about anything)

So I had a choice, betablockers or increase Cipralex again. I opted for the Cipralex. I've made peace with the fact that I might have to take Cipralex forever. So eversince I've been on 20mg Cipralex my heartbeats feel normal. I've had a bad episode involving the death of my father in law which opened up files about my own fathers death years ago. So, I've been to psychiatrist again a month ago and he increased my dosage to 30mg daily.

I only discovered yesterday that this medicine could affect your QT interval for your heart beat.

I'm so confused about continuing Cipralex. Won't I cause permanent heart damage continuing with 30mg cipralex?

a Friend told me to make an apointment with my psychiatrist and let him phone the cardiologist and they sort it out. What do you guys think?

H

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I've only been on Citalopram for a few months - less than a year - and I had palpitations whilst exercising once it was increased from 10mg to 20mg. The doctor was pretty worried and ran an ECG. Whilst I had some sort of abnormality, it was very minor, and may even be considered normal for someone of my height/weight/age. They're keeping an eye on it but I might need to change meds anyway at some point due to the amount I sleep during the day since starting these meds.

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Thankfully I got off of citalopram awhile back. I have had heart palpitations on and off for years (even before ADs). I haven't had these issues in awhile, and I am now on Wellbutrum. Btw, I was a heavy smoker (had the palpitations before that as well), but Wellbutrum had stopped my craving for cigarettes altogether. I no longer smoke, unless under crazy stress, then I will smoke 1 (it takes a lot to push me to smoke), but I do vape (use ecigs). It doesn't surprise me that an AD can cause palpitations, but that is something scary. I personally did not feel any benefit from taking citalopram (used for the depression & anxiety linked to having PTSD).

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I take Lexapro and did experience some fast heart beats once...thought it was just anxiety acting up.

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I have been on Cipralex for about 12 years now - I'm on 20mg's. I found when I first started them, they were fantastic and did help with the panic attacks and depression however as the years have gone in - 12 years on. I do feel they are in need of being changed but the problem there is - I am extremely sensitive to AD's, therefore it's really hard to find one that does not give me side effects. Just over 2 years ago, my Psychiatrist tried to change my AD's to "Citalopram" but to be honest, these almost sent me over the edge completely so I was put back on Cipralex. It's got to the stage where I am only existing everyday, have no interests at all, avoid talking as I don't feel the strength to do so and when I do, I ramble (talk very quickly) another thing how my family know I'm not right. I do feel at my wits end, don't know where to turn, what to do, hate who I am, hate everything about myself and that black hole is getting closer and closer to me. So I think the best thing to do even though I am so sensitive to medication is when I go back to my Psychiatrist (hopefully very soon rather than later) ask to be put on something else as the Cipralex just are not doing anything anymore. Don't get me wrong, I was put on 30mg's of Cipralex which they only do on rare cases (I guess I'm one rare case) but it made me feel like a shell so they put them back down to 20mg's. I do know the last time I was at my Psychiatrist he wanted me to have an ECG done and wants one done a yearly now - so Cipralex must be known to give fast heart beats. 

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I used Fluvoxamine for over a decade and have been using Lexapro/Sipralexa since a few months now. It does work but I am tapering it down because it causes too much insomnia. My doctor suggested upping to 20 mg and taking Lorazepam but I ignored that advice. Medication ending on "pam" means its a benzodiazepine and I really dont want go down that road. I found great comfort though in using Trazolan(Trazodone).

Did you managed to sleep on the Sipralexa?

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