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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by joef on August 2, 2013, at 23:00:42
does anyone know which ssri's/ssnri's do not affect the heart rythym....believe there was a recent article citing celexa and Lexapro-don't know specifics...particulary interested to know about ..Prozac, Zoloft,paxil and the new viibryd.....this subject is really never mentioned
Posted by Phillipa on August 3, 2013, at 10:06:20
In reply to ssri's/heart rythyms, posted by joef on August 2, 2013, at 23:00:42
Joe I've seen it mentioned in nursing newsletters. Search for ad's that don't effect heart rhythm. I think the jury is out on this but the TCA's all seem to. SSRI's are the least. Phillipa
Posted by joef on August 3, 2013, at 16:53:56
In reply to Re: ssri's/heart rythyms » joef, posted by Phillipa on August 3, 2013, at 10:06:20
thanks...a subject that gets little attention
Posted by Phillipa on August 3, 2013, at 21:53:26
In reply to Re: ssri's/heart rythyms, posted by joef on August 3, 2013, at 16:53:56
I wonder why as it should shouldn't it?
Posted by larry hoover on August 3, 2013, at 22:37:07
In reply to ssri's/heart rythyms, posted by joef on August 2, 2013, at 23:00:42
> does anyone know which ssri's/ssnri's do not affect the heart rythym....believe there was a recent article citing celexa and Lexapro-don't know specifics...particulary interested to know about ..Prozac, Zoloft,paxil and the new viibryd.....this subject is really never mentioned
I just checked pubmed, and among the SSRIs, the QT interval prolongation is associated strongly with citalopram (Celexa), and to a lesser extent the S-enantiomer escitalopram (Lexapro). No other SSRI was associated with that effect in a fairly large cross-sectional Japanese study. Tricyclics can cause rhythm problems, too.
Lar
Posted by SLS on August 4, 2013, at 0:50:58
In reply to Re: ssri's/heart rythyms » joef, posted by larry hoover on August 3, 2013, at 22:37:07
> > does anyone know which ssri's/ssnri's do not affect the heart rythym....believe there was a recent article citing celexa and Lexapro-don't know specifics...particulary interested to know about ..Prozac, Zoloft,paxil and the new viibryd.....this subject is really never mentioned
>
> I just checked pubmed, and among the SSRIs, the QT interval prolongation is associated strongly with citalopram (Celexa), and to a lesser extent the S-enantiomer escitalopram (Lexapro). No other SSRI was associated with that effect in a fairly large cross-sectional Japanese study. Tricyclics can cause rhythm problems, too.
>
> Lar
>
>It's nice to see your smiling face...
:-)
- Scott
Posted by joef on August 4, 2013, at 6:39:23
In reply to Re: ssri's/heart rythyms » larry hoover, posted by SLS on August 4, 2013, at 0:50:58
does anyone where viibryd falls in to this category......and if you have coronary disease(stents)) would these be dangerous to you?
Posted by larry hoover on August 4, 2013, at 10:41:37
In reply to Re: ssri's/heart rythyms » larry hoover, posted by SLS on August 4, 2013, at 0:50:58
> It's nice to see your smiling face...
>
> :-)
>
>
> - ScottThanks Scott, but I regret that my smile was short-lived. Details on admin.
<sigh>
Lar
Posted by larry hoover on August 4, 2013, at 10:59:01
In reply to Re: ssri's/heart rythyms, posted by joef on August 4, 2013, at 6:39:23
> does anyone where viibryd falls in to this category......and if you have coronary disease(stents)) would these be dangerous to you?
Vibryd was specifically cleared of this issue, here: http://www.ncbi.nlm.nih.gov/pubmed/23611569
Next time you see your cardiologist, I'd bring it up, for assurance. Your case history is more worthy of consideration, IMHO, than would be the use of Vibryd.
Lar
Posted by joef on August 4, 2013, at 19:55:14
In reply to Re: ssri's/heart rythyms » joef, posted by larry hoover on August 4, 2013, at 10:59:01
thanks for the information
Posted by ed_uk2010 on August 5, 2013, at 15:14:21
In reply to ssri's/heart rythyms, posted by joef on August 2, 2013, at 23:00:42
Citalopram (and possibly escitalopram) can affect cardiac conduction, but they do not normally affect the heart rhythm in people with structurally normal hearts. I would not recommend citalopram for a patient with serious underlying heart disease.
Other SSRIs do not appear to affect cardiac conduction. Sertraline (Zoloft) is a first-line antidepressant for patients with heart disease because it does not affect the heart rhythm and it does not interact significantly with most cardiac drugs.
Serotonin is needed for normal platelet function, and ALL SSRIs are associated with a bleeding risk, which may be relevant to patients on long-term aspirin, clopidogrel (Plavix) or warfarin for cardiovascular disease. The risk of bleeding into the stomach is particularly increased, and some patients are prescribed a proton pump inhibitor (eg. Prilosec) to reduce the risk. (Proton pump inhibitors are only prescribed with SSRIs in those at particularly high risk of gastric bleeding, not otherwise). Non-serotonergic antidepressants are not associated with bleeding, but many have other cardiovascular effects.
Posted by SLS on August 5, 2013, at 16:32:49
In reply to Re: ssri's/heart rythyms, posted by ed_uk2010 on August 5, 2013, at 15:14:21
Hi Ed.
Nice post.
Thanks.
- Scott
Posted by Lamdage22 on August 6, 2013, at 6:00:37
In reply to Re: ssri's/heart rythyms, posted by joef on August 3, 2013, at 16:53:56
Funky side effects. Another reason to just go and try to make life easier with natural Meds.
There is enough out there for depression. No reason to go with real drugs if your depression is mild to medium.
Posted by nerdmom1959 on August 24, 2013, at 12:22:02
In reply to Re: ssri's/heart rythyms, posted by Lamdage22 on August 6, 2013, at 6:00:37
I had to stop Lexapro because it prolonged my QT. Only SSRI-type drug that doesn't cause this in susceptible people is Viibryd.
This is the end of the thread.
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