I am under treatment for anxiety and panic attacks since 2020 i am taking dveniz 50 which contains desvenlafaxine an SNRI drug b/d and clonazepam 0.25 b/d and trifluoperazine 1mg after dinner but I noticed that my heart rate was constantly over 100 and sometime 130 and with light activity it was going above 150 but without any symptoms i came to know from my apple watch so i consulted cardiologist who performed ecg and echo both were normal and he diagnosed me with inappropriate sinus tachycardia and prescribed inapure 15 but my psychiatrist instead advised me to take betablocker to reduce my heart rate as it also helps in anxiety so he added metoprolol xl 25 before breakfast but before breakfast still my heart rate is high if i perform any activity and only after taking metoprolol xl 25 it goes back to normal but i am worried i am on too many meds especially a heart medication without any problem I don't have bp issue too but with meds anxiety is controlled but i always feel fatigued