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Dr. Andrew Rynne

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Are pounding heart, chest pain and anxiety associated with bipolar disorder?

Answered by
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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2751 Questions

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Posted on Fri, 11 Jan 2019 in Mental Health
Question: I have been suffering from Bipolar depression for several years now. I have taken many anti depressions which made me feel worse. I had found a medication for mood swings called Lamotragine and it worked like a charm for a couple of years. I had a ruptured brain aneurysm back in 2013, and after a few months, the medication stopped working. I have been trying mood swing meds. they don't make me feel worse but they are hardly helping. These are fairly new symptoms... Pounding heart, chest pain and anxiety which happens most of the time when I wake up in the morning. The only thing that works is lorazapm. After taking this, the chest pain begins to slow down. Sometimes I dread going to bed at night, because I know what is waiting for me in the morning. This happens when ever I wake up from a nap as well. I don't know how much more of this I can take. It's ruining my life. I don't even remember what happiness or XXXXXXX is anymore.. I forgot.
doctor
Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
It is most likely due to anxiety.

Detailed Answer:

Hello,

I read your query and understand your concerns.

From the available description it is clear that the palpitations, chest pain and anxiety are related. It will not be wrong to say that the palpitations are result of anxiety other than anything else.

The points in favour of above opinion are as follows
1. Palpitations and chest pain are are well known anxiety symptoms
2. Comorbidity with anxiety is very common with bipolar disorder (almost 60%)
3. Response to lorazepam indicates that anti-anxiety medications help the problem which again supports anxiety as the cause
4. Poor response to ongoing medications indicates that conventional medications are ineffective.
5. Worsening of symptoms in morning indicates weaning effect of medication.

In my opinion you need to follow your psychiatrist and psychologist.

I hope this helps you.

Feel free to write back to me if you have more questions.

Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ashok Kumar 4 hours later
I don't have palpitations. I have heavy pounding. I have mentioned to my psychologist and she has no Idea. I don't understand what you mean by "weaning affect of medication. This all started, I believe from a horrible experience in an intake hospital. I when in hoping they could find something to help with my bipolar and at the same time, they will be equipt with lorazapm if I have an attack. Even though I had a discharge sheet from the er doctor saying, go on lorazapm. 1 in the morning and one at night. They refused to give me the lorazapm and it was shortly after that these horrible symptoms started.
doctor
Answered by Dr. Ashok Kumar 16 hours later
Brief Answer:
Follow up

Detailed Answer:

Hello,

Thanks for follow up.

I like to assure you that pounding in the chest in association with anxiety and chest pain is palpitations rather than anything else. It does not mean that everyone should call it palpitations but it is important to state that this is most likely anxiety symptoms as explained above.

Regarding weaning effect of the medication, I like to state that the serum concentration is at the lowest level during morning hours which causes increase burden of a symptom during morning hours.

I hope this helps you further.

Feel free to write back to me if you have more clarifications.

Thanks again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ashok Kumar 25 hours later
Thank you very much...My doctor has prescribed a different mood stabilizer yesterday and I feel a bit better. We'll see over time if it will help or if it is just hope
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Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
Follow up.

Detailed Answer:

Hello,

Thanks for the information.

I am glad to know that the new medication helping you and hope that the improvement will be much better with the progress of time.

Thanks and regards,
Dr. Ashok Kumar, Psychiatrist

Above answer was peer-reviewed by : Dr. Prasad
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