Posted by: boo01 | 2009-02-06


Hey doc its me yet again! I am feeling much better but not quite all there! I just want to bring to your attention something that still bothers me and I know you probably sick of it but my skipped/extra beats freak me out alot and I believe they are being caused by my SSRI which is cipramil infact on 40mg they more pronounced while on 20mg they still there and not as pronunced now I have researched SSRIS and there are reports of QT intervals and arythmias etc although I have been checked by a cardiologist not many of them know the effects of drugs apart from that I have been on and off this drug for years. I dont find it effective my psychiatrist says the body can never become immune to it he brushes all of my side effects away its annoying because not everything can be blamed on anxiety I am concerned for myself as I hate medication long term when it produces side effects like this I just want to know if this can be resolved or is there an alternative drug I find CBT very effective as I have never done it before rather that than popping pills!

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Our expert says:
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Nice to hear from a Better Boo. Occasional irregularities of heart beat can our on various antidepressants and a surprising number of other drugs ; and many people don't even notice them. When we do, and when we get worried about it, the anxiety can add to the effect, and a spiral of anxiety can result. Cardiologists, yes, may not be familiar with all psych drugs, though I'd expect them to be reasonably familiar with those which may have cariac side-effects. Remember also, some effects appear and may be significant when the drug is taken in an overdose, and not have a significant effect when taken in normal doses. The cardiologist presumabyl did an ECG and was able to directly examine the patterns of electrical activity of your heart, and to see that they are OK and not sinister.
One's body indeed does not become immune to the effects of a specific antidepressant ( or to the buynch of them). I suppose it is possible that the precise chemical nature of one's depression might shift, such that a different medication might in time become more effective. There are numerous other antidepressants available, including a number of SSRI's ( the family that seems to have suited you better earlier ) or some of a different chemical profile.
I'm pleased to hear you find CBT effective. You clearly have a very powerful mind, and when this applies itself to issues that scare you, this could enhance the whole anxiety aspect of these problems --- but if the same power, concentration and thoroughness get harnessed by CBT towards becoming immune to unfruitful worries, and to avoiding negative thoughts, etc., you should be better at it than most.

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