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What Does Low Pulse Rate While On Lithium, Propranolol And Prozac Indicate?

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Posted on Mon, 9 Jan 2017
Question: My 41 year old son who takes Latuda, Lithium, propranolol and Prozac had a pulse rate of 50 earlier this evening. He is sleeping now. His skin feels clammy to the touch. I am planning to call his primary care doctor today. Should I take him to the ER? My e-mail address is YYYY@YYYY
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Answered by Dr. Rishu Saxena (25 minutes later)
Brief Answer:
Take your son to ER as early as possible.

Detailed Answer:

Hi Dear,
Have noted all your details

Your son is on a number of medications for pyschiatric illness.
Propranolol is a beta blocker and bradycardia is one of the commonest and most frequently encountered adverse effect of this medicine.
Drowsiness, letharge ,low blood pressure and bradycardia is also a side effect of Latuda.
Fluoxetine (prozac) also causes bradycardia,and drowsiness.
Even, lithium can slow down the heart ; as long term intake causes hypothyroidism. The drug can cause reduce function of the thyroid gland known as hypothyroidism. When the thyroid hormone level in the blood is low, heart rate can come down. All these changes are reversible by discontinuing lithium.

He is on a combination of anti psychotic drugs, these drugs should be closely monitored,as margin of safety of these drugs is very low,even a slight increase in serum level of these drugs can create a lot of problems.

Take you son to the ER as soon as possible, serum level of these drugs needs to be checked there .Ask your pyschiatrist to taper few drugs if he can.

Thank you
In case you have any more query ,feel free to ask,i would be happy to help you!

Dr Rishu Saxena
Cardiologist and Physician
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Does Low Pulse Rate While On Lithium, Propranolol And Prozac Indicate?

Brief Answer: Take your son to ER as early as possible. Detailed Answer: Hi Dear, Have noted all your details Your son is on a number of medications for pyschiatric illness. Propranolol is a beta blocker and bradycardia is one of the commonest and most frequently encountered adverse effect of this medicine. Drowsiness, letharge ,low blood pressure and bradycardia is also a side effect of Latuda. Fluoxetine (prozac) also causes bradycardia,and drowsiness. Even, lithium can slow down the heart ; as long term intake causes hypothyroidism. The drug can cause reduce function of the thyroid gland known as hypothyroidism. When the thyroid hormone level in the blood is low, heart rate can come down. All these changes are reversible by discontinuing lithium. He is on a combination of anti psychotic drugs, these drugs should be closely monitored,as margin of safety of these drugs is very low,even a slight increase in serum level of these drugs can create a lot of problems. Take you son to the ER as soon as possible, serum level of these drugs needs to be checked there .Ask your pyschiatrist to taper few drugs if he can. Thank you In case you have any more query ,feel free to ask,i would be happy to help you! Dr Rishu Saxena Cardiologist and Physician