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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Propranolol And Sertraline Treat Severe Depression And Chronic Anxiety Disorder Causing Chest Pain And Panic Attack?

I suffer from severe depression and chronic anxiety disorder. I've tried citalopram which worked perfectly for 2 years then stopped working. I then tried mirtazapine which made symptoms worse but kept trying for 4.5 weeks but nothing worked. Now I'm on week 3.5 of sertraline 50mg and I'm still having bad side effects. The worst happened this morning, I woke and instantly had my heart racing, chest pain, tight chest, couldn't catch my breath so I took propranolol 40mg. It slowed my usually fast heart rate to 57bpm and now I feel very weak, tight chest, sweating and feel like I'm wheezing or my breathing is very uncomfortable. Is this expected or is this a bad reaction to the propranolol? I've only taken 4 tablets over the past few days and only 1 out of the 4 times did it make me feel steady and calm. How long will it take for the tablet I took today to wear off? I've had to take lorazapam to calm myself a little now even though I'm trying to come off them. This is the worst and longest panic attack / chest pain, tightness / palpitations / can't calm I've ever had. Could it be from the sertraline still starting up? Or could it just be the propranolol slowing my heart so much?

What should I do next? Not take propranolol again, cut the dose in half? Just take lorazepam (although I won't be prescribed them anymore after a few weeks)

Thanks
Louisa
Thu, 3 Apr 2014
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Psychiatrist 's  Response
Hi
Thanks for using healthcare magic

That side effects may be due to propranolol. In that case, you can stop it. You are taking sertraline 50mg and it is the minimum effective dose of sertraline. Better to increase it upto 100 or 150mg and with that carry on low dose anxiolytic like clonazepam. You can try relaxation exercise like JPMR, that would help you.

Thanks
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Can Propranolol And Sertraline Treat Severe Depression And Chronic Anxiety Disorder Causing Chest Pain And Panic Attack?

Hi Thanks for using healthcare magic That side effects may be due to propranolol. In that case, you can stop it. You are taking sertraline 50mg and it is the minimum effective dose of sertraline. Better to increase it upto 100 or 150mg and with that carry on low dose anxiolytic like clonazepam. You can try relaxation exercise like JPMR, that would help you. Thanks