struggling

Anxiety and PVCs

by Gemita - 2021-07-18 06:25:11

Dear Athena, I don't like to hear you are struggling.  I have not taken Lexapro which I see is used for depression or generalised anxiety, but it will I fear give you the symptoms of fatigue you so describe.  It may also, especially at higher doses, increase the risk for irregular heart beats, so this may well be partly the cause for your worsening PVCs too.

Two thoughts.  A beta blocker (low dose) can be used to help treat both your anxiety and your PVCs and may help to calm everything down a little.  It did for me.  I am taking Bisoprolol.  I would ask your GP about a beta blocker as a possible alternative option, if you are not already taking one?.  Also I would recommend "talking therapy" - cognitive behavioural therapy - always over medication therapy or at least to ask your GP if you could work with a therapist for a period of time as well.  Both depression and anxiety are helped by unloading our fears, by talking about our feelings.  Sometimes this is a very painful process - I have been through this too Athena - but by getting what we most fear out into the open, it may relieve your pain.  It is worth a try at least.

In the meantime, you have us and there are lots of warm hearted folks here who have been through similar experiences with both PVCs and anxiety who are willing and able to help.  When you are afraid of something, write it down and try to understand where that fear is coming from, what is fuelling that fear.  By confronting it, understanding it, we can better control our feelings and symptoms like a racing heart or palpitations which is why working with a therapist is so helpful to start the process of overcoming anxiety or depression.  Medication may be helpful and necessary initially but long term I would look for an alternative, often more effective treatment, and in my opinion that is with talking therapy. 

May I add in view of your deteriorating symptoms on night shift, you could perhaps ask your employer whether there is a possibility of switching back to day work, or engage the help of your GP.  Anxiety is an illness and you obviously need help to get better.  Additionally, i would get your electrolytes checked + thyroid function.  Both of these can trigger worsening palpitations.  Also make sure you are drinking plenty of water because dehydration may worsen on certain meds, including I believe some anti depressant/anxiety meds and dehydration is a strong trigger of palpitations for many of us.  I wish you well Athena.

Gemita xx

Anxiety, palpitations, escitalopram.

by Selwyn - 2021-07-18 09:28:25

Hi Athena 123,

Any anxiety that has been going on for months, with medical management,  without improvement,  is worth a change of approach. 

First, let's look at the cause? Without addressing the cause of your anxiety, medication is going to be protracted. You need to look at alternatives, eg. talking therapy based on psychology. ( CBT or similar). Get to grips with the underlying cause - get professional help to do this if you have struggled yourself and got no where. The alternative is meds. These help if the cause of the anxiety is self limiting, however in the long run, the only way of getting better is addressing the cause. 

Escitalopram (Lexapro) can sometimes worsen anxiety and can cause palpitations.  It is a bad idea to try to stop escitalopram suddenly  as you need to be weaned off this SLOWLY, otherwise you get rebound anxiety.

Knowing the cause of your palpitations ( ?PVCs) is desirable. An ECG/event recorder ( eg. Kardia)> having a physical check eg. electrolytes/thyroid function ( as mentioned by Gemita) is indicated.

Some types of beta blockers are especially good for anxiety symptoms.

Avoid tea/coffee/cola containing caffeine. You should be alcohol and caffeine free, as these substances worsen anxiety. Exercise is the greatest help. 

Shift work is associated with anxiety and depression, it can also cause heart arrhythmias ( My atrial fibrillation is worse with tiredness, as is most people with paroxysmal AF).

See the  light at the end of the tunnel - cure is better than the application of a band-aid ( medication). Try to get to grips with the cause of  your anxiety.  Learn some tools you can use to alleviate the symptoms for life. These can be taught, like any learning.

Best wishes for a speedy change of  plan and recovery.

Med adjustment

by Julros - 2021-07-18 10:20:41

Athena, I am sorry you having to endure this. I think you are correct in seeking the help of a psychiatrist for adjustments in your medication. And yes, if you are not aleady in counselling, consider this as well. 

I worked night shift for years, and sleep deprivation was a really problem for me. I hope you are doing all you can to get restful sleep. 

I can relate

by TLee - 2021-07-18 12:05:45

I have been dealing with a somewhat similar situation. I don't suffer from an anxiety disorder, my issue has always been depression. I finally made the decision to ask my doctor for medication when it became too much to manage on my own. Now I feel so sleepy that it is a struggle to stay awake to get through my day. I recently switched from taking my anti depressant (Cymbalta) in the morning to taking it at night. Too soon to tell if this is going to help. You have the added problem of working nights, so I would think this confuses things even more. I think that if it is at all possible you should try and change that.

As far as completely weaning off the anxiety meds, if that is a possibility it may help wth the fatigue, BUT I feel that for some people that may not work. Some disorders, particularly anxiety disorders, are rooted in our genetic make-up & may not respond to other forms of therapy (not saying don't try it--it is worth trying). For me, I think I am looking at trying to find medication & dosage that works without the overpowering, constant sleepiness. I still have hope that I will eventually address my symptoms, including those of the arrythmia that landed me here on this forum, without side effects causing more problems. I am with you on that journey--keep trying & keep the faith! 

Lexapro - Not for Me!

by arent80 - 2021-07-18 13:59:54

Hi there! 
I was on Lexapro for a while. Started at 5, then 10, then 15. I took the 15 for two days and said no more. It killed my energy and my libido. I also had a sleep study don't at the end of March and was diagnosed with Periodic Leg Movement Syndrome. The doctor told me the Lexapro is notorious for making this worse and possibly low iron. I had my iron checked and it was low as well. She had me change to Wellbutrin. To be honest I don't like it and am leaning towards going to Cymbalta as my Psychiatrist says it helps with anxiety and pain. Needless to say it's all trial and error mixed with a LOT of patience. Slowly taper off the lex and the. Start something else. Don't give up but please make sure you taper off slow. Being on 20mg I'd say the taper would take quite a few months but that's just my opinion. Hope you get better soon. God bless!

Alejandro 

Specialist

by Persephone - 2021-07-18 16:46:47

Yes, for potent drugs such as Lexapro, I agree that a psychiatrist is needed for management.  A primary care provider (PCP) is not going to have the background - I'm not trying to question their ability, but they have many other things to do, as compared to a specialist. You of course need to keep up with the PCP if you do seek care elsewhere, for the overall effects of the drug on your body.  I was able to stop lexapro (prescribed by my PCP) without tapering (when I was much younger than I am now and before PM) but I was on a low dose - don't remember the numbers now.  My next PCP prescribed a beta blocker and that has been sufficient for me.  I don't enjoy having to rely on it if I feel strong anxiety, but I can take it as needed and for me it has been a preferable fix to a daily drug. I resent having to keep asking for the prescription to be refilled once per year because I feel like I get push-back - not to sound too cynical, but f I were on lexapro there probably would be no questions, just the auto refill - and I could go on and on about how our health care systems are lacking in providing adequate mental health care, but that's beyond our discussion here.  I hope you're able to arrive at a resolution that works for you.

much appreciated

by athena123 - 2021-07-18 22:37:18

Thank you again for all you do, my company has an employee assistance program that offers free counseling with CBT. I made an appointment and will try it because i need to heal myself so i can be there for my family whom i had to rely on for so many months. This is all a life changer for me as with a lot of the people on this site  who are so strong and are willing to lend a hand. thank you for not only the advice but for being a friend. appreciate it from my heart. 

I used CBT and successfully weaned from lexapro

by asully - 2021-07-19 00:39:35

I just wanted to give you some hope that CBT does work, with the advice of both a psychologist and a psychiatric nurse practitioner (for prescriptions and weaning).  I was able to use lexapro to bridge the gap while I did therapy.  As my therapy progressed and anxiety levels got better I was able to slowly reduce my dose over time and eventually stop taking it.  I was on lexapro for about 2 years and although I don't think it caused palpitations or increased my anxiety it made me groggy, did a number on my sex drive, and made me semi-emotionless.  It DID help reduce my anxiety, and was a fantastic short term tool while I worked on practicing CBT, mindfulness, and other types of therapeutic thechniques.

Each person can have different results from SSRIs and also different symptoms as they begin to reduce an SSRI.  Make sure you are being monitored by a prescriber and a therapist, and that both can talk if you choose to go this route.

My prescriber and I call it "nosexapro".