Severe bradycardia on Zoloft?

[gothic_beauty]

Why would this happen? I started taking 25 mg of Zoloft this week, and after taking my fourth pill was woken up in the middle of the night with severe nausea and a racing heart that dropped very suddenly to an extremely slow rate of 35 beats per minute. My heart rate has never been anywhere close to there. I also felt very dizzy and faint, and there was a loud ringing in my ears. I was positive my heart was about to stop. Within a few minutes that felt like a few hours, my symptoms thankfully eased up. I have since stopped taking Zoloft--I'll have to find another way to combat my anxiety--but I can't stop obsessing about this horrible episode. I have heard many negative side effects reported after using Zoloft, but nothing like this. What do you think happened to me???

[gothic_beauty]

Thanks so much for explaining that: it makes a lot of sense. I guess it's sort of like what happens when I run really fast and then stop abruptly: I usually feel a few really slow heartbeats after I do that. This particular episode felt awful, but I'm glad it wasn't a completely inappropriate response from my body. No more Zoloft for me though ... I am trying Lexapro right now but will talk to my doctor about Paxil if it doesn't work.

I may be afraid to go to sleep now, though ... (just kidding!)

[is_something_wrong]

I agree with Tom regarding the Paxil, as this drug has no heart effects (no EKG changes or blood pressure changes). It better for us somewhat "obsessed" about our hearts ;-) We can't give any advice but discuss it with your doctor. If I should ever take a SSRI, it would be Paxil.

Xanax is not prescribed here for long events of anxiety, so I can't say anything about that.

To your symptoms, it sounds like a classical vasovagal episode. It's very typical that it happens after an "inappropriate" episode of rapid heart rhythm. What happens is that your pressure sensors in the aorta and carotid arteries find your blood pressure higher than necessary (but not necessarily "high") and "jams" the brake pedal, which may result in a very slow heart rate (in some people down to the 20s causing fainting). The blood pressure will usually drop quite a bit along with this. In my case it happens occationally when standing up too quickly after eating large meals, I get this rapid heart rate and the body suddenly changes its mind for a few seconds. It's not dangerous but it feels terrible, because the heart beats very hard.

If this happens a lot, you should ask your doctor, of course. Otherwise, you can rest assured that your heart rate drops to the low 40s or high 30s several times each night anyway, when you are sleeping. As my cardiologist said, "if you knew all the weird stuff a heart does during sleep, you would never dare to sleep. Haha!"

I'm joking, but the truth is, the heart can do a lot of weird stuff that is not dangerous..

[gothic_beauty]

Thanks alot, achillea. You have no idea how much your words reassure me. Unfortunately, it was a GP who put me on Zoloft. I would love to see a psychiatrist, which I believe would be a much better long-term solution for me than medication in any case, but I just can't afford one right now. So expensive! I will definitely get in touch with my GP though, and see what she thinks. I realise that different SSRIs affect different people in different ways, and I might have to try a few different ones before I find one that works for me. I am hesitant to do so after my bad experience with Zoloft, but you've given me hope. I will give it another shot.

Thank you as well, Tom. I remember you telling me about your wife's condition, and how she was able to identify what was causing her anxiety (her mother, if I'm not mistaken.) A fine success story, and I'm glad she's doing better. Again, psychiatric counselling isn't an option for me now as far as I can tell, due to financial concerns, but hopefully it will be in the future. Until then, I will talk to my doctor about Paxil. She actually wants to try me on Lexapro next, about which I have also heard good things. Do you know anything about Lexapro?

[tom_h]

This is just my completely unprofessional opinion, but who is married to someone who formerly HAD severe anxiety neurosis and panic disorder.  You know that I have responded to your posts before so I am aware of your situation. I would think that Paroxetine aka. Paxil would be better suited to your condition than Zoloft.

You can mask the symptoms with drugs or you can see someone who specialized in anxiety disorders and work to unlearn your body's response to certain situations, and why you responded to the situations in the first place.

Paxil, Alprazolam (Xanax), and some psychological counciling.  That would be my "prescription".  That combination worked miracles for my wife who is operates near normal today, and who can now deal with situations that formerly caused her to melt down.

[achillea]

You have just begun taking a small dose of Zoloft this week, and in the beginning, what many people feel are primarily side effects.  In general, the actual beneficial effects of the drug are not felt for an *entire* month.

While I have found that drugs in this class can be enormously helpful for anxiety--and it is terrific that you are willing to entertain the idea of medications yourself--one size does not fit all in the SSRI department.  Some individuals will feel better on one SSRI than another, and what makes one person feel great may make another feel crappy.  A patient my have to try several to find the best one (I went through four, as I recall).

Nausea, sleep disturbances, and funny dreams are pretty common side effects, but your symptoms sound as though you had an episode involving very low blood pressure--a near-faint, in other words. It could have been a side effect of the Zoloft, a night terror type of experience, or a Vasovagal response to fear.

I know you are preoccupied by the idea that your heart will stop, but that ain't in the realm of possibility.  Just touching on that thought will fill you with instantaneous terror, and you should by now be aware of the effect that terror has on the Vagus nerve.

You need to get back in touch with the doc who prescribed this medication.   I would hope the physician in question is a psychiatrist, not a GP, by the way.  You want a specialist in this matter, and he/she should be in close contact with you for the first couple of months you are taking any psych medications.  If this is not the case, a different doc is in order.