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Do antidepressants worsen premature ventricular contraction?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

Is it safe to start Sertraline if I have premature ventricular contractions? My PVCs tend to get worse when I experience strong emotions, like anger, panic attacks, or crying. My psychiatrist suggested Sertraline, but I have heard it can cause arrhythmia. Is PVC already a type of arrhythmia? I had an echocardiogram in November after being hospitalized for PVCs (Postural tachycardia syndrome), and everything came back normal except for mild LVH and mild mitral valve regurgitation. I am worried that starting this antidepressant might make my PVCs worse or lead to a more serious arrhythmia or even sudden cardiac arrest (SCA).

Kindly help.

Hello,

Welcome to icliniq.com.

I understand your concern.

Premature ventricular contractions (PVCs) are a type of arrhythmia where the heart beats early from the ventricles. While PVCs are common and usually harmless, they can get worse with stress, anxiety, or strong emotions. Sertraline is an antidepressant commonly used to treat anxiety and depression.

Research shows that Sertraline is generally safe for people with heart conditions, according to the American Medical Association. The British Heart Foundation also recommends Sertraline as the first-choice antidepressant for people with heart disease.

However, there have been rare reports of serious arrhythmias, like QT prolongation and Torsades de Pointes, in patients taking Sertraline. While these cases are rare, it is important to be cautious.

You should start Sertraline carefully, with close monitoring by your healthcare provider. This may include baseline and follow-up electrocardiograms (ECGs) to check for any changes in your heart. It is also important to monitor potassium and magnesium levels, as imbalances can increase the risk of arrhythmias.

Although Sertraline is usually safe for people with your condition, it is important to discuss all your medications with both your cardiologist and psychiatrist. Each should be aware of the other medications you are taking.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Medically reviewed byiCliniq medical review team

Published At March 15, 2025
Reviewed AtMarch 15, 2025

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