Doctor is prescribing an anti depressant: Will it affect my pacemaker?

Posted by sramsaier @sramsaier, Nov 12, 2023

My doctor is prescribing an antidepressant. Will it affect my pacemaker?

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Not that I know of, but more importantly, are you convinced the prescribing authority knows of all other conditions? If so, and the prescription stands, I would not worry.

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I posted a reply to this but don't see it. My Mayo psychiatric APN wanted to prescribe a antidepressant for my PTSD anxiety/panic disorder. She knew I had a ICD/Pacemaker. The medication had a side affect of conduction delay in heart. She checked with my heart failure doctor and my EP doctor and was told it was okay to prescribe it.

It would not affect you pacemaker but could affect your heart conduction. Always asked about things like this to your provider and ensure they check with your other medical providers.

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Fellow ICD recipient and PTSD sufferer here. I have been shocked and have even had a “storm” resulting in multiple shocks. It resulted in PTSD to a pretty drastic extent. I was prescribed an antidepressant by my electrophysiologist to help my anxiety and such.
I can tell you that it has helped my situation and has not adversely affected my heart health.
I wholeheartedly agree with the other comments about getting the opinion of an expert before you proceed, but I sure wouldn’t hesitate if you get the OK.
That’s just my experience, hopefully it can provide you with a little more clarity.

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@irishpeaks

Fellow ICD recipient and PTSD sufferer here. I have been shocked and have even had a “storm” resulting in multiple shocks. It resulted in PTSD to a pretty drastic extent. I was prescribed an antidepressant by my electrophysiologist to help my anxiety and such.
I can tell you that it has helped my situation and has not adversely affected my heart health.
I wholeheartedly agree with the other comments about getting the opinion of an expert before you proceed, but I sure wouldn’t hesitate if you get the OK.
That’s just my experience, hopefully it can provide you with a little more clarity.

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irishpeaks, I was, and in, the same boat. Several years ago I had 5 ICD shocks in a 24 hour period. It was devastating to deal with. I developed PTSD Anxiety/Panic Disorder out of it.

I am not sure of the number here but the Mayo Psychiatric Department had me do a test and anything over a 15 was definitely PTSD. My number score was double that. That is when the anxiety medications was recommended but had side affects on heart conduction (something about causing a delay in a electrical signal) and then the pyschiatric provider doing a complete team approach and consensus from all my specialist to agree on best option and medication being recommended for my PTSD anxiety/panic disorder.

Along with that medications and a lot of fine tuning my pacemaker the PTSD Anxiety/Panic Disorder has improved where I went from not wanting to leave house due to fear of a shock and embarrassment to occasionally worrying about it in crowded situations.

I exercise a lot and that too help reduce my stress over this. I am not sure everyone knows the tremendous shock you get with an ICD shock. It is really traumatic on your body and you have no control at all. Then those who have had one will agree having a panic/anxiety attack is another very upsetting situation that I hope I never had another one again.

Getting your health providers working as a team is critical. That is what I like about Mayo as they did just that when deciding how to treat my PTSD Anxiety/Panic Disorder with medications which really did and does help.

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@jc76

irishpeaks, I was, and in, the same boat. Several years ago I had 5 ICD shocks in a 24 hour period. It was devastating to deal with. I developed PTSD Anxiety/Panic Disorder out of it.

I am not sure of the number here but the Mayo Psychiatric Department had me do a test and anything over a 15 was definitely PTSD. My number score was double that. That is when the anxiety medications was recommended but had side affects on heart conduction (something about causing a delay in a electrical signal) and then the pyschiatric provider doing a complete team approach and consensus from all my specialist to agree on best option and medication being recommended for my PTSD anxiety/panic disorder.

Along with that medications and a lot of fine tuning my pacemaker the PTSD Anxiety/Panic Disorder has improved where I went from not wanting to leave house due to fear of a shock and embarrassment to occasionally worrying about it in crowded situations.

I exercise a lot and that too help reduce my stress over this. I am not sure everyone knows the tremendous shock you get with an ICD shock. It is really traumatic on your body and you have no control at all. Then those who have had one will agree having a panic/anxiety attack is another very upsetting situation that I hope I never had another one again.

Getting your health providers working as a team is critical. That is what I like about Mayo as they did just that when deciding how to treat my PTSD Anxiety/Panic Disorder with medications which really did and does help.

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Sounds like they have things sorted out and have you headed in the right direction, glad to hear it.
Ironically I have worked as an electrician for a couple of decades and have taken some incidental shocks throughout my career. That being said, there is nothing that comes even remotely close to what an ICD shock delivers. It is beyond comprehension until one has experienced it. There’s plenty of “tough guys” that say they just brush it off and keep going, but that’s complete nonsense. It is a very traumatic situation and hard to describe.
It’s been close to two years since my last shock, so I have been able to “relax” about the situation some. Meds have definitely helped along with the passing time.
Keep fighting the good fight and glad to hear of other successes in the treatment of this issue.

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@irishpeaks

Sounds like they have things sorted out and have you headed in the right direction, glad to hear it.
Ironically I have worked as an electrician for a couple of decades and have taken some incidental shocks throughout my career. That being said, there is nothing that comes even remotely close to what an ICD shock delivers. It is beyond comprehension until one has experienced it. There’s plenty of “tough guys” that say they just brush it off and keep going, but that’s complete nonsense. It is a very traumatic situation and hard to describe.
It’s been close to two years since my last shock, so I have been able to “relax” about the situation some. Meds have definitely helped along with the passing time.
Keep fighting the good fight and glad to hear of other successes in the treatment of this issue.

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irishpeaks, Yes we both know it is not something that is easily dealt with and leaves it scars on you that are not physical but mental.

I joke with my EP and say that everyone in EP division should have the same type shock so they can feel what patient feel and maybe can understand the tremendous stress it causes. They smile at me.

One good point that help me deal with having it was one visit one of the nurses said to me, "It is like having your own EMS in your chest ready to give you life saving shock when you need it."

That very comment is what I think about when I start to feel the stress of having it. I do know without it I would not be here. It takes only 4 minutes to start basically "dying" and far to many EMS or medical personnel are not there quick enough to do CPR or administer a shock to those who do not have ICDs.

I think I read that 99% of time the shock will bring heart back to rhythm. Problem is they did not say it would keep it there!!!!!!!!

Glad to hear you have not had any for a couple of years. Hope I can get back to that. The time I had the 5 shocks I had not had a ICD shock for the 10 years I had the device.
Good luck!!!

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sramsaier, I think on your first post I replied would not affect your pacemaker. I want to clarify that you pacemaker is programed by your EP (Electrophysiology) pace department and any changes to the operation of your pacemaker is from programming or device defects.

Clarifying, anxiety medications do have side affects (which can affect the electrical and function of your heart) like all medications. That is why when my psychiatric medical provider wanting to prescribe anxiety medications she did so with a team approach like I mentioned is important.

My psychiatric APA knew the medications she wanted to put me on caused a change in a electrical wave function thus wanted to get approval from the EP department and my heart failure doctor who approved the medication before she prescribed and had me take it.

I was a basket case for awhile and was taking Trazodone to help me sleep. Alprazolam (for relaxation), and Escitalopram for anxiety. My psychiatric care giver and I worked slowly to change the Trazodone and Alprazolam from taking every day to as needed (rarely take in now for over a year).

The difference was she wanted me to stay on the Escitalopram indefinitely. That is the anxiety medication she wants me to stay on indefinitely. I think it does help. I just wanted to clarify my post about not affecting pacemaker.

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If this is an SSRI, you probably cannot take it with a blood thinner if you are on one.

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