HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Are Heart Palpitations, Dry Mouth And Fatigue Indicative Of A Serious Health Concern?

Posted on Fri, 16 Apr 2021

Question: I just felt out of it before, and as I was speaking to my aunty it felt like I fell asleep a couple of times, like nodding off, or blacking out, and missing time. I had an intense feeling that I was dying, heart was racing, dry mouth. I thought it was my usual medicine i took half an hour before; Ritalin, but I've never had this before. I felt really tired like I was falling asleep. i don't know how to explain it, but I am really scared. I take lamictal 200mg twice daily, six ritalin tablets, 10mg, a day, over every four hours throughout the course of a day. will i die? is this a bad sign of something. it kind of reminds me of when I had an allergic reaction to acuphase in 2007. I felt so out of it, heart beating fast, and scared. It is the same as when you're laying in bed at night nodding on and off :(

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Are you prescribed Ritalin by a doctor? That is a very high dose. I would recommend lowering it significantly, because it is causing panic attacks in you. It might also be damaging your heart. I recommend visiting a doctor to obtain an EKG of the heart.

Dr. Sheppe

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Alexander H. Sheppe (31 minutes later)

my heart is fine. why did i black out, or lose time like i qas nodding off? could it of been a dissociative seizure?

my heart has been checked regiarly; no abnormalities.

Answered by Dr. Alexander H. Sheppe (11 hours later)

Brief Answer:
Followup

Detailed Answer:
When did you last have an EKG and echocardiogram?

Are you prescribed Ritalin by a doctor? That is a very high dose. I would recommend lowering it significantly, because it is causing panic attacks (these are panic attacks not seizures) in you.

Dr. Sheppe

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (4 hours later)

Thank you. yes, it is my psychiatrist. I had these things for year prior to taking this medication.

Answered by Dr. Alexander H. Sheppe (4 hours later)

Brief Answer:
Followup

Detailed Answer:
I recommend you talk with your psychiatrist about slowly stopping all Ritalin use as it is causing major panic and anxiety symptoms in you. Once Ritalin is stopped, you could seek treatment with an SSRI medication like Lexapro and/or weekly psychotherapy for anxiety.

Dr. Sheppe

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Alexander H. Sheppe (1 hour later)

I have Bipolar disorder, and take Lamictal, and Diazepam. The massive anxiety spells happen in the absence of ritalin, and have done for many years. as you know, ssri's are useless in BPd

Answered by Dr. Alexander H. Sheppe (17 hours later)

Brief Answer:
Followup

Detailed Answer:
SSRIs have limited efficacy for depression in BPD, but are highly effective for anxiety. Therefore my recommendations stands that O\once Ritalin is stopped, you could seek treatment with an SSRI medication like Lexapro and/or weekly psychotherapy for anxiety.

Dr. Sheppe

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (2 hours later)

oh, the whole reason I was taken of ssri's was due to heightened anxiety, and more frequent hypomanic episodes. If this anxiett happened for years before, and in absence of Ritalin (which I only started a few years ago), why are you so adamantly recommending the cessation of it?? I appreciate your professional response

Answered by Dr. Alexander H. Sheppe (2 hours later)

Brief Answer:
Followup

Detailed Answer:
Ritalin universally worsens anxiety, and you are on massive doses of it. Removing it is the first step to getting anxiety under control. SSRIs are very unlikely to cause hypomania and are indicated for the treatment of anxiety once other offending agents are removed.

Dr. Sheppe

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Alexander H. Sheppe (1 hour later)

Thanks. the anti depressants made me hypomanic, one of the clues in my diagnosis of type two bipolar. they made me interactive, or extremely depressed! that's why when you do a questionnaire, they question how you reacted to antidepressants. thanks for your help, my friend

Answered by Dr. Alexander H. Sheppe (2 hours later)

Brief Answer:
Followup

Detailed Answer:
If you prefer not to use SSRIs, there are other antidepressants with an even smaller risk of hypomania, such as Wellbutrin or Remeron, which are also very useful in treating anxiety. I would consider those as well!

Dr. Sheppe

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy