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Dr. Andrew Rynne

Family Physician

Exp 50 years

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On medication for depression. Feeling premature heartbeat and advised betacp 40 TR. Any thoughts?

Answered by
Dr. Mayank Bhargava

Internal Medicine Specialist

Practicing since :2003

Answered : 1658 Questions

Posted on Mon, 24 Dec 2012 in Heart Rate and Rhythm Disorders
Question: hi
i am a patient of depression...taking anti-depressents since last 4 years of different bands. Namely xet cr, paxidep cr. Right now I am taking Paxidep Cr 12.5 one a day along with Loanzep MD .5 one a day. Problem is I am feeling some pre-mature heart beats now a days. Feel like skipping beats for a fraction of second few times in day. Docotr has advised me Betacp 40 TR. But still having the problem in some extent. Not sure why? Is it related to medicine that I am taking or something else. FYI, I had my ECG, TMT tests ok even before 4-5 months. But my lipid profile is not in good side.
Answered by Dr. Mayank Bhargava 2 hours later
Thanks for posting your query
Paxidep (Paroxetine) and Lonazep (clonazepam) both medicines don't have premature heart beats feeling (also called as "Palpitations" in medical terminology) as their side effects.
Palpitations may be due to heart problem or due to hormonal disturbances.
Your ECG & TMT is normal as already mentioned by you, there is least chances of heart involvement.
You should again consult with your treating doctors and should go for 48/ 72 hours holter monitioring as ECG at any time indicates only 1-2 minutes heart reading.
While holter monitoring speaks about 48/72 hours heart reading.
You should also go for Thyroid profile.
If all these investigations are normal then there is high chances of Panic attacks.
In such conditions, you should consult with XXXXXXX medicines specialist or psychiatrist.
Let me know the status of your lipid profile also.
In my opinion you shouldn't take Betacap, A beta blocker, as beta blocker are contraindicated in extra or missed beats.
Hope that helps
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Mayank Bhargava 2 hours later
Thanks Dr. XXXXXXX for ur quick response. I would like to add the below facts (habits) of mine for your information:
1. Drink: Toal 180 ml alcohol in a week. In 2 times.
2. Smoke: 5-6 cig. a day

Test reslts of Lipid proifle (April, 2012):
1. Serum HDL: 38 mg/dl
2. Serum LDL: 167 mg/dl
3. Serum Triglycerides: 222 mg/dl
(I am not talking any medicine for the above abnormalities)

Also I already went through Thyroid test and fortunately that is negative.

Please let me know your further suggestion(s).

Thanks again!

Answered by Dr. Mayank Bhargava 26 minutes later
Alcohol intake 180 ml/ week is acceptable and you can continue. You should take alcohol not more than this amount.
You should stop smoking as you have deranged lipid profile.
Treatment of lipid disorders is decided by LDL and you have only one risk factor (smoking). LDL up to 160 is acceptable.
Though you have increased triglycerides (222 mg%) and you should low fat diet along with fenofibrate on written prescription from your treating XXXXXXX medicine specialist.
Hope for the normal thyroid profile level.
Put your queries if you have.
Best regards,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Mayank Bhargava 10 minutes later
Sorry Dr. XXXXXXX I tried to mean I have a very normal Thyroid profile. No abnormalities from that end.

If I stop smoking, is there anything else that I should worry about?
I will also go for low fat diet.
I am also thinking of light cardio vascular exercises like skipping and sit up.

Should I be worry about 'Palpitations'? My panic disorder is also related to cardio phobia. I panic about that only.

Thanks in advance for your suggestion.

Answered by Dr. Mayank Bhargava 7 minutes later
Keep your positive attitude for leaving your smoking habit.
You should also keep keen eyes on the lipid profile status as this must be in normal range.
You should go for skipping, jogging and at least 30 minutes brisk walk daily for healthy life.
If you have normal holter monitoring then there is high chances of panic attacks then you should consult with psychiatrist once again for treatment.
Your panic attacks may be due to worry about your heart status and deranged lipid profile.
Hope this will solve your query.
Dr. Mayank Bhargava
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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