Is Zoloft safe for heart?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern. Zoloft (Sertraline) is an effective and safe SSRI (selective serotonin reuptake inhibitor) for managing anxiety disorder. Zoloft is generally considered a low risk for QTc (is an electrocardiogram representation of ventricular depolarization and repolarization) prolongation in healthy people. I can see that you had three ECGs in the last few months with QTc between 400 to 420 which is within normal limits. Zoloft in traditional doses (up to 200 mg daily) usually does not cause any significant increase in QTc. You are only on 150 mg once daily. So highly unlikely to have an adverse reaction. Can I ask why you are particularly worried about QTc prolongation and sudden cardiac death? Do you have any relevant risk factor like a previous heart problem or family history of arrhythmias and heart problems? Were these repeat ECGs done for any specific reason or only because of your anxiety? If you are otherwise healthy, Zoloft is generally safe. If you need any other medication for other reasons, remind your doctor that you are on Zoloft so that they can avoid prescribing medication that can potentially interact together. Also, street drugs are not advisable. Regarding your other query about Ativan (Lorazepam), you can continue gradually weaning till you are off completely. When reduced gradually chances of withdrawal effects are much lesser. It is good that you are stopping Ativan as it is not recommended for long term use. I note that you are currently in therapy. It will help to address your longstanding anxiety and develop better psychological coping strategies. It is common to experience worsening of your symptoms when you lose a loved one. Hopefully, you will recover gradually from the loss. You can also try deep breathing techniques and progressive muscular relaxation for managing stress and anxiety. I will also advise you to discuss your worry about QTc prolongation with your prescribing doctor. He will be able to monitor and advise you accordingly. Hope this helps. Thank you and take care.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern. I can understand your excessive worry about QTc prolongation, and since you are working in ICU it is easy to get fixated on it (I sometimes feel that working in the medical field is like a double-edged sword). But as I mentioned earlier, in the absence of any relevant cardiac history personally or in the family, there is no need in getting repeated ECG's done. All your QTc readings so far have been within normal limits. There is no added risk in taking Sertraline at the prescribed doses. Just to put your mind at ease regarding Sertraline, it is safe enough to be used in several cardiac patients when their depression or anxiety needs to be treated. Have you considered whether that this fixation on QTc prolongation and sudden death can be a part of health anxiety? I will recommend to discuss it with your prescribing doctor and therapist so that this can be explored further and if needed appropriate intervention to tackle high anxiety levels can be considered. Regarding Ativan, you have already successfully tapered down to a shallow dose. Chances of any withdrawal symptoms are highly unlikely hereafter. You can continue taking 0.125 mg every other day for another couple of weeks and then stop if you are feeling comfortable. Hope this helps. Thank you and take care.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern. There is nothing particularly worrying about your personal or family cardiac history. So you can continue taking Zoloft tablets safely as prescribed. Health anxiety can be effectively managed by psychological therapy and taking the tablet Zoloft. Discuss with your therapist about CBT based approach. You may also find help by visiting a few self-help resources online. Also lifestyle interventions are key in managing your overall stress levels. You may know that anxiety worsens when your stress levels are higher. So take active steps to manage stress in your personal and professional life. Medical work is demanding, so ensure your work-life balance is always prioritized. If you have an interest, try yoga as well. In addition to the positive effect on physical health, it also has beneficial effects on emotional well-being. Hope this helps. Thanks and take care.

Hi,

Welcome back to icliniq.com.

I read your query and can understand your concern. Yes, getting back to yoga and completing therapy will be helpful. Your query about doing blood tests & EKGs (electrocardiograms) while prescribing the tablet Zoloft or other SSRIs (selective serotonin reuptake inhibitors) is very pertinent. Not all patients who are going to be started on SSRIs need blood tests & EKGs. It depends on the clinical history, family history, and physical examination. It is common for a complete blood cell count, metabolic panel, and thyroid levels to be done if a patient is newly diagnosed with depression or anxiety. You may not need a repeat monitoring blood test unless there is any new symptom or sign. Routine monitoring of blood tests is not needed in this case. Likewise, routine EKG is not needed for SSRIs within recommended dose unless there is any relevant personal or family cardiac history, as I mentioned earlier. Hope this helps. Thanks and take care.