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Matt
Posted on Tuesday, June 07, 2005 - 11:13 am:   

can anxiety effect the qt interval?
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Friday, June 10, 2005 - 08:26 pm:   

Yes, most by affecting the heart rate
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sfroj
Posted on Sunday, July 17, 2005 - 11:21 pm:   

If I have anxiety (now) from being diagnosed with MVP and LOng QT--is there any harm with taking zoloft for anxiety?
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Monday, July 18, 2005 - 08:40 am:   

Zoloft is generally to be avoided by Long QT syndrome patients. You have to discuss that with you doctor.
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Bionic Roadrunner
Posted on Monday, July 18, 2005 - 02:05 pm:   

Dr Kanters, what are the effects of Zoloft on the heart, please?
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Monday, July 18, 2005 - 09:28 pm:   

It has QT prolonging effects
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Bionic Roadrunner
Posted on Monday, July 18, 2005 - 10:55 pm:   

Thank you Dr Kanters.
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sfroj
Posted on Tuesday, July 19, 2005 - 06:26 am:   

Dr. Kanters--When I looked at the long qt drugs to avoid sheet I didn't see Zoloft on there. Where is there a updated list of drugs to avoid? Are there any antianxiety drugs that are safe whith long QT?

The reason I am asking is that I passed out in April and eversince have had problems with lightheadedness and headaches ands on occasion major chills. The Ekg that my doctor did the day of my fainting showed sinus bradycardia and long QT (<500). My primary didn't seen concerned with the long Qt and said she wouldn't call it long. My cardiologist adressed that that I have long Qt but really didn't say anything about it.Finally after numerous tests thay found I had MVP and the 30 day event monitor showed lots of PVCs when I was experiencing symptoms. I am using atenolol (low dose because of baseline low Bp to start). It seems like the atenolol is helping because I'm not having dizziness as often and when I do I;'m not feeling skip beats when I take my pulse. When I reasearched I found there is something called mitral valve prolapse syndrome which seems to incorporate a lot of my symptoms I'm experiencing. Many have said that they use a antianxiety/antidepressent to help contol their dizziness and anxiety symptoms that many with MVP are prone to.

Sorry for being so long. Are there antianxiety drugs that are safe with long QT?
Also, there doesn't seem like there is much you can about long QT but be aware of it. Is there any chance that my long qt made me pass out or is there any way to really tell? What are some questions that I should make sure I ask my MD about long QT?
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Bionic Roadrunner
Posted on Tuesday, July 19, 2005 - 06:02 pm:   

I cannot answer all your questions, but here is a web address for a list of drugs to avoid for long QT patients: www.qtdrugs.org
It is updated very regularly and like you, last time I checked it, Zoloft was not on it. I think it must have been added recently, because it is now on it.
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Tuesday, July 19, 2005 - 10:40 pm:   

Zoloft is on the list. It is a serotonine reuptake inhibitor which most of them (if not all) inhibits the HERG channel mimicing LQT2.

Benzodiazepines (Diazepam) does not have this feature, but has other disadvantages
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sfroj
Posted on Wednesday, July 20, 2005 - 05:32 am:   

Drugs that are on the list like in the category 3 and 4--ie Zoloft, if you take it, it doesn't guarantee it will elongate the QT correct? And if you take a medication that does make the QT longer, is it only for as long as you take the medication or does it make permanent effects?
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Bionic Roadrunner
Posted on Wednesday, July 20, 2005 - 05:16 pm:   

Dr Kanters,
Do you feel that a borderline patient with the LQT2 gene and who has never had any problem and is taking beta blocker for prevention would still be at risk with Zoloft, considering the fact that this patient has been on Zoloft for 3 years and is doing fine?
Would you recommend stopping Zoloft?
Thank you for your time!
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Thursday, July 21, 2005 - 09:05 am:   

It can non be answered precisely.

It is a weight between the two problems.

I have a LQTS patient with severe schizophrenia and a LQT2 mutation. Never any LQTS related symptoms.

The patients major problem is not LQTS but the schizophrenia. In that case I continued with several drugs on the forbidden list.


There is a small risk taking Zoloft, but the risk of reducing quality of life without Zoloft are also substantial.

It is an individual decision which only can be made between you and your electrophysiologist.
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Bionic Roadrunner
Posted on Thursday, July 21, 2005 - 01:01 pm:   

Thank you Dr Kanters. It is a very difficult decision to make!
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Bionic Roadrunner
Posted on Thursday, July 21, 2005 - 01:14 pm:   

Dr Kanters,I should have asked you, which medicine would be safe for anxiety/panic attack disorders since all the SSRI's seem to prolong the QT interval?
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sfroj
Posted on Friday, July 22, 2005 - 01:57 am:   

iS LEXAPRO OK TO TAKE IF YOU HAVE LONG QT? i WOULD BE INTERESTED TOO IN A LIST OF MEDS FOR ANXIETY/PANIC ATTACK THAT ARE OK IF YOU HAVE LONG QT.
THANK YOU
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Thursday, July 28, 2005 - 01:18 pm:   

The best place to look is at www.qtdrugs.org which have the most updated list of drugs.
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julie treece
Posted on Thursday, September 29, 2005 - 11:20 pm:   

Dr. Kanters,
My child has chronic childhood arthirtis and prolonged qt. She has been prescibed a new drug, Enbrel (etanercept), it is an injectible medicine. This drug is not listed on the qtdrug sight, but it is differnt than most listed. What do you think.
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Dr. Jorgen Kanters
Username: Jorgen

Registered: 08-2003
Posted on Friday, October 07, 2005 - 07:55 am:   

I dont know.

I have looked in the literature and there is no indication of etanercept should affect the QT interval. All new drugs are extensive investigated for QT effects, and there is no warnings on etanercept, so Im pretty sure there is no problems. You could ask your rheumatologist to contact the drug company and ask if etanercept had any effects on the QT interval
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Bionic Roadrunner
Posted on Thursday, January 12, 2006 - 03:42 am:   

Because some patients with LQTS are experiencing anxiety and or depression, I wrote to the people who maintain the "qtdrugs.org" site to ask if there was any drug for those problems that would not prolong the qt wave. They were kind enough to send me their answer (and I am quoting):

"Not all anti-anxiety/antidepressant drugs as a class of medicine pose the same risks for those with LQTS. One drug that we cannot, at this time, find evidence to suggest that it might be a risk is Bupropion (Wellbutrin). On the other hand, there is some evidence to suggest that citalopram (Celexa) poses a greater risk than some of the others in the anti-anxiety/antidepressant class. In general, these drugs pose a risk when taken in high doses or overdoses, so for those who absolutely need medication, it is particularly important that they be taken as directed and under close medical supervision. Regardless, we recommend that you start any drug under the close supervision of your provider who knows your history, your current health status and your other medications and can fit any potential risk factors into the entire risk of adding a medication."

I hope this will help some of you. Remember that you should never take anything without your doctor's approval, even over the counter and herbal remedies.





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Rebecca Vaughan
Posted on Thursday, January 12, 2006 - 09:08 pm:   

Well that's scary for me. I have taken Celexa for about five years and experienced my first "episode" 2.5 years after starting it. My EP has suggested I continue taking it as I do have depression. Recently I started Wellbutrin as my depression has a vegetative quality and I have noticed a difference and like it. I have started to wean myself off the Celexa.
Dr. Kanters: Did I understand your above post that Celexa (all SSRIs")can mimic LQT 2 by interfering with the HERG channel?
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Rebecca Vaughan
Posted on Thursday, January 12, 2006 - 09:10 pm:   

Also Dr. Kanters,
Do you recommend any EP specialist in the Denver area?
Thank you.

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